The Complexity of Late Life Depression: Bridging Methods and Clinical Substance

描述(由申请者提供)：本提案是关于K01指导研究科学家发展奖的。申请者是康奈尔高级干预和服务研究中心(ACISR)的流行病学家和发展中的研究员。她的目标是发展成为一名独立的研究员，专注于晚期抑郁症的临床流行病学，专门研究弥合方法学和临床实质之间的学科鸿沟的策略，目的是减轻老年抑郁症的负担。她实现这一目标的方法是学习先进的方法，以解决关于老年性抑郁症的发病、病程和结果的复杂临床问题，并了解干预措施如何改变与这一过程相关的健康下降。拟议的培训和研究计划旨在相辅相成。具体的培训目标是学习：1)与精神病理学的心理社会和环境因素有关的先进研究方法；2)关于心脑血管疾病与精神病理学、认知和抑郁的关系的临床概念；3)临床试验研究；4)复杂的基于人群的抽样和基于人群的随机干预研究。这项研究旨在加深我们对老年精神病学两个前沿问题的理解。第一个项目解决了老年性抑郁症的病因学理论之一--血管抑郁假说，并提出问题：外周和中央血管疾病指数在多大程度上是老年人抑郁症状的危险因素？第二项研究调查抑郁症的过程和结果，并问：随着时间的推移，抑郁症干预在多大程度上改变了老年人抑郁症和残疾之间的关系？这项研究将使用两个已建立的基于人群的纵向数据集进行，每个数据集都提供了一个独特的机会来测试适当数据很少的假设：心血管健康研究(CHS)和预防初级保健老年人自杀：合作试验(PROPE)。使用这些数据来测试与老年抑郁症的复杂性相关的假设的概念和方法上的挑战将加强申请者的正规培训。

DESCRIPTION (provided by applicant): This proposal is for a K01 Mentored Research Scientist Development Award. The applicant is an epidemiologist and developing investigator at the Cornell Advanced Center of Interventions and Services Research (ACISR). Her goal is to develop into an independent investigator who focuses on the clinical epidemiology of late life depression, specializing in strategies to bridge the disciplinary gap between methodology and clinical substance with the aim to reduce the burden of late life depression. Her approach to achieving this goal is to learn advanced methodology in order to address complex clinical questions on the onset, course, and outcomes of geriatric depression, and to understand how interventions can modify the decline in health associated with this course. The proposed training and research plans are designed to complement and reinforce each other. The specific training objectives are to learn about: 1) advanced research methods related to psychosocial and environmental factors of psychopathology, 2) clinical concepts about the relationship of cardiovascular/cerebrovascular disease to psychopathology, cognition and depression, 3) clinical trials research, and 4) complex population-based sampling and population-based randomized intervention studies. The research is designed to further our understanding of two leading-edge questions in geriatric psychiatry The first project addresses one of the etiological theories of geriatric depression, the 'Vascular depression" hypothesis, and asks: To what extent do indices of peripheral and central vascular disease act as risk factors for depressive symptoms in older adults? The second investigates the course and outcomes of depression, and asks: To what extent do depression-interventions modify the relationship between depression and disability over time in older adults? The research will be conducted using two established population-based, longitudinal data sets, each offering an unique opportunity to test hypotheses for which appropriate data are rarely available: the Cardiovascular Health Study (CHS) and the Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT). The conceptual and methodological challenges of using these data to test hypotheses related to the complexities of geriatric depression will reinforce the applicant's formal training.