Claude D Pepper Older Americans Independence Center at Yale

耶鲁大学的OAIC活动将侧重于多因素的老年健康状况--老年人常见的健康状况 由多种因素组合而成的人，这可以通过多因素干预来预防，以及 这会引发多种可能的结果。在前几期OAIC支持的基础上，我们将 重点找出障碍的解决方案，这些障碍阻碍了对病因、预防、 多因素老年疾病的治疗和结果。我们提出的投资组合包括：1)调查 从老年人的新视角看传统疾病实体，如复发性ML和肺炎 症状模型；2)方法学项目，将我们的流行病学和干预研究提高到一个新的水平 通过开发纵向方法来分析诱发事件对结果的影响以及 处理风险因素或治疗与结果之间常见的双向(反馈循环) 和确定多因素干预策略的作用机制的方法；3)新的应用 现有技术，如地理信息系统，用于评估 实际实施多因素干预；4)分类、分析和传播新的 现有的多个域的测量方法，供所有OAlc的调查人员使用；5)探索性项目，如 制定一项战略，在面对多因素的老年健康时确定老年人的治疗目标 条件；6)利用意想不到的研究机会并鼓励潜在的翻译 以一项拟议的试点为例的研究，该试点检查氧化应激响应性的变化 人类的衰老。最后一个项目特别令人兴奋，因为在细胞层面指导这项工作的范例 与那些指导耶鲁OAIC在人类层面上工作的人类似，从而提供了突破性发现的希望 关于多因素老年健康状况的病因、预防和治疗。 为了支持这些项目和其他项目，耶鲁开放式课程将包括以下核心内容：1)领导力/行政； 2)研究职业生涯发展，提供早期职业生涯、过渡性职业生涯和附属教师的发展 奖项；3)试点/探索性研究；4)实地研究；5)数据管理/信息学；6)生物统计学。

Yale OAIC activities will focus on multifactorial geriatric health conditions-health conditions common among older persons that result from combinations of multiple factors, that may be prevented by multifactorial interventions, and that trigger multiple possible outcomes. Building on the foundation laid over previous periods of OAIC support, we will focus on identifying solutions to barriers impeding a more complete understanding of the etiology, prevention, treatment, and outcomes of multifactorial geriatric conditions. We propose a portfolio that includes: 1) investigations of traditional disease entities such as recurrent Ml and pneumonia from the novel perspective of the geriatric syndrome model; 2) methodologic projects that take our epidemiologic and intervention studies to the next level of complexity by developing longitudinal methods for analyzing the effect of precipitating events on outcomes and for handling the common occurrence of bi-directionality (feed back loops) between risk factor or treatment and outcome and methods for determining the mechanisms of action of multifactorial intervention strategies; 3)novel applications of existing technologies, such as Geographic Information Systems, to evaluate the penetration, and effectiveness, of real world implementation of multifactorial interventions; 4) the categorization, analysis, and dissemination of new and existing measures of multiple domains for use by investigators throughout all OAlCs; 5) exploratory projects such as the development of a strategy for eliciting older persons' treatment goals when faced with multifactorial geriatric health conditions; and 6) capitalizing on unanticipated research opportunities and encouraging potential translational research as exemplified by a proposed pilot which examines alterations in oxidative stress responsiveness with human aging. This last project is particularly exciting because the paradigms guiding this work at the cellular level parallel those guiding Yale OAIC work at the human level, thus offering the promise of breakthrough discoveries concerning the etiology, prevention and treatment, of multifactorial geriatric health conditions. To support these, and other, projects the Yale OAIC will include the following cores: 1)leadership/administrative; 2)research career development which will offer early career, transitional career, and affiliated faculty, development awards; 3) Pilot/exploratory studies; 4) Field; 5) Data Management/Informatics; 6) Biostatistics.