The major goal of this training program is the development of career scientists with the knowledge base and expertise needed to conduct programmatic basic and/or clinical research in the neuro-psychiatric disorders of late-life. The most rapidly expanding segment of the United States population is the group over the age of 65, and specifically those older than 85 years. As the population ages, the prevalence of late life disorders will correspondingly increase. Clinical, translational and basic science researchers must be trained who have the interest and expertise to study these disorders and develop new treatments. The training for fellows includes a program of didactics (research design, statistics, special issues in the study of late-life neuro-psychiatric disorders, the conduct of responsible research and grant preparation) and mentored research. The faculty involved in mentoring fellows includes multiple disciplines, e.g. psychiatrists and neurologists, and a broad range of expertise including epidemiology, genetics, imaging, clinical trials and animal models. This T-32 was first funded in 1998. Of the 22 fellows enrolled in the last 10 years, 41% are women, 14% belong to groups classified as minorities, and 55% are MDs and 45% PhDs. There are five current fellows, four second-year fellows and one third-year fellow. Since the T-32 will not be funded as of 6/30/08, the four second-year fellows will end their training after only two years and are considered graduates. The graduation rate is 86% (19/22);of the 19 fellows who have graduated the program, 32% have received K awards and five have a K award currently under review. Thus 58% of graduates or current fellows have received a K award or have one under review. In total, 65% of graduates have received substantial independent funding including K awards, NARSAD awards and grants from the American Foundation for Suicide Prevention, Alzheimer's Association and other funding agencies. Of the 22 fellows who entered the program, 15 of 22 (68%) are in full-time research positions. The first submission for a competitive renewal was submitted on 5/12/07 and reviewed on 10/24/07 and received a priority score of 204. At that review, """"""""the committee considered this to be a very strong application"""""""" and was """"""""impressed with the past record of the program."""""""" However, the committee raised a number of concerns including: 1) turnover of faculty, 2) the integration of new faculty into the program, 3) the ability to recruit psychiatrists to the fellowship and the absence of a pipeline of applicants through recruiting medical students or psychiatric residents and 4) the integration of basic and clinical research mentors and the relationship of this program to the CTSA program at Columbia. This submission details the very considerable revisions in the training program that have been made to address the issues raises in the previous review. This application asks for five years of funding to continue training the next generation of researchers in late-life neuro-psychiatric disorders. By the year 2030, there will be 65 million Americans over the age of 65, representing 22% of the population. In the same time period, the number of Americans 85 and older will more than double. As the population ages, the prevalence of late life psychiatric disorders will correspondingly increase. However, there is a shortage of clinical and basic researchers focused on psychiatric disorders in the elderly, and there are few programs with a specific mission to train researchers in this area.
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