Cornell ACISR in Late Life Depression

康奈尔 ACISR 在晚年抑郁症中的应用

• 批准号: 8465906
• 负责人: GEORGE S ALEXOPOULOS
• 金额: $ 162.98万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-26 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8465906
• 关键词: Biological; Caring; Clinic; Clinical; Communities; Community Practice; Complex; County; Depressed mood; Development; Disease; Elderly; Ethics; Family; Fostering; Goals; Government; Health; Healthcare; Home environment; Hospitals; Incubators; Intervention; Learning; Logistics; Medical; Mental Depression; Mental Health; Mission; Modeling; Morbidity - disease rate; Pathology; Patients; Poverty; Primary Health Care; Public Health; Recording of previous events; Rehabilitation therapy; Research; Research Methodology; Research Personnel; Resources; Structure; System; Testing; Training Activity; Training Support; Translating; Treatment outcome; Work; adverse outcome; cost; disability; experience; geriatric depression; geriatric mental health; meetings; method development; mortality; neglect; novel; preempt; programs; psychosocial; research and development; social

The mission of the proposed ACISR is to produce and disseminate comprehensive interventions that effectively target the complex clinical and social factors contributing to late-life depression, minimize the splintering of health care, and can be implemented under the current health reimbursement system. The rapid increase of older persons (73% increase is anticipated in US by year 2020) and the diseases and disabilities complicating their care make geriatric research a national priority. We focus on late-life depression because it is the leading cause of disability, increases medical morbidity and mortality, causes suffering, family disruption, and increases the cost of care. We propose a challenging program that expands our studies on clinical, psychosocial, and biological predictors of depression treatment outcomes and uses these findings and our clinical experience to develop interventions personalized at the patient and the setting level with the goal to preempt adverse consequences of late-life depression. To maximize our impact we will work both in settings in which most depressed elders receive care (primary care) and in settings serving elders with special clinical (disability) and social needs (poverty). To shorten the road from discovery to practice we plan to do most of this work in the community and together with our community partners. Our community partner will be the Westchester Geriatric Mental Health Coalition, which consists of medical practices, community mental health clinics, home healthcare agencies, rehabilitation hospitals, and government organizations who share our concerns. We propose to use Westchester County as an "incubator" of novel interventions, which we will further test at a national level in order to establish their public health significance. We are confident that we can meet the challenges of this work because of: 1. Our organizational experience in integrating research, methodology, community, and training activities into a cohesive, seamlessly-working system; 2. our research structures for ethics, scientific and logistic support, and training of staff; 3. our "know-how", history and explicit plans in developing sustained partnerships with community agencies and learning from them; 4. our expertise in research methods development; and 5. our record and commitment to fostering the development of new investigators that will continue to invigorate our field. This application proposes a model of research development that can rapidly translate clinical, psychosocial, and biological findings into personalized interventions, shorten the way from discovery to community practice and benefit many depressed seniors, including those with severe pathology and limited resources who are neglected by traditional research.

拟议的ACISR的使命是制定和传播全面的干预措施，有效针对导致晚年抑郁症的复杂临床和社会因素，最大限度地减少医疗保健的分裂，并可在当前的健康补偿制度下实施。老年人口的迅速增加(预计到2020年美国将增加73%)，以及使他们的护理复杂化的疾病和残疾，使老年研究成为国家优先事项。我们关注晚年抑郁症，因为它是导致残疾的主要原因，增加了医疗发病率和死亡率，导致痛苦、家庭破裂，并增加了护理成本。我们提出了一个具有挑战性的计划，扩大我们对抑郁症治疗结果的临床、心理社会和生物学预测因素的研究，并利用这些发现和我们的临床经验来开发在患者和背景水平个性化的干预措施，目标是先发制人，预防老年抑郁症的不良后果。为了最大限度地发挥我们的影响，我们将在大多数抑郁症老年人得到护理(初级护理)的环境中工作，并在为有特殊临床需要和社会需要的老年人提供服务的环境中工作(残疾)和社会需求(贫困)。为了缩短从发现到实践的道路，我们计划在社区中和我们的社区合作伙伴一起完成大部分这项工作。 我们的社区合作伙伴将是Westchester老年精神健康联盟，该联盟由医疗机构、社区精神卫生诊所、家庭保健机构、康复医院和与我们有同样关切的政府组织组成。我们建议将威彻斯特县作为新干预措施的“孵化器”，我们将在国家一级进一步测试，以确定其对公共卫生的意义。 我们有信心迎接这项工作的挑战，因为：1.我们在将研究、方法、社区和培训活动整合为一个紧密、无缝的工作系统方面的组织经验；2.我们在道德、科学和后勤支持以及工作人员培训方面的研究结构；3.我们在与社区机构发展持续伙伴关系和向他们学习方面的“诀窍”、历史和明确计划；4.我们在研究方法开发方面的专业知识；以及5.我们促进新调查人员发展的记录和承诺，这将继续活跃我们的领域。这项应用提出了一种研究发展模式，可以迅速将临床、心理社会和生物学发现转化为个性化干预，缩短从发现到社区实践的道路，并使许多抑郁的老年人受益，包括那些患有严重疾病和资源有限的人，这些人被传统研究忽视。

项目成果

Pharmacotherapy for late-life depression.

• DOI: 10.4088/jcp.7085tx2cj
• 发表时间: 2011-01
• 期刊: The Journal of clinical psychiatry
• 作者: Alexopoulos GS

Problem adaptation therapy for older adults with major depression and cognitive impairment: a randomized clinical trial.

• DOI: 10.1001/jamapsychiatry.2014.1305
• 发表时间: 2015-01
• 期刊: JAMA psychiatry
• 影响因子: 25.8
• 作者: Kiosses DN;Ravdin LD;Gross JJ;Raue P;Kotbi N;Alexopoulos GS
• 通讯作者: Alexopoulos GS

Amyloid Hypothesis: Is There a Role for Antiamyloid Treatment in Late-Life Depression?

• DOI: 10.1016/j.jagp.2015.12.003
• 发表时间: 2016-03
• 期刊: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
• 作者: Mahgoub N;Alexopoulos GS
• 通讯作者: Alexopoulos GS

PROTECT: A Pilot Program to Integrate Mental Health Treatment Into Elder Abuse Services for Older Women.

保护：将心理健康治疗纳入老年妇女虐待服务的试点计划。

• DOI: 10.1080/08946566.2015.1088422
• 发表时间: 2015
• 期刊: Journal of elder abuse & neglect
• 影响因子: 1.9
• 作者: Sirey,JoAnne;Halkett,Ashley;Chambers,Stephanie;Salamone,Aurora;Bruce,MarthaL;Raue,PatrickJ;Berman,Jacquelin
• 通讯作者: Berman,Jacquelin

Feasibility of integrating mental health screening and services into routine elder abuse practice to improve client outcomes.

• DOI: 10.1080/08946566.2015.1008086
• 发表时间: 2015
• 期刊: Journal of elder abuse & neglect
• 影响因子: 1.9
• 作者: Sirey JA;Berman J;Salamone A;DePasquale A;Halkett A;Raeifar E;Banerjee S;Bruce ML;Raue PJ
• 通讯作者: Raue PJ