Cornell ACISR in Late Life Depression

康奈尔 ACISR 在晚年抑郁症中的应用

• 批准号: 7921453
• 负责人: GEORGE S ALEXOPOULOS
• 金额: $ 197万
• 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 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7921453
• 关键词: Cornell; ACISR; Late; Life; Depression

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，并可以在当前的医疗报销制度下实施。老年人数量的迅速增加（预计到 2020 年美国将增加 73%）以及使老年人护理复杂化的疾病和残疾使老年医学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，增加医疗发病率和死亡率，造成痛苦、家庭破裂，并增加护理成本。我们提出了一项具有挑战性的计划，扩大我们对抑郁症治疗结果的临床、社会心理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制定针对患者和环境水平的个性化干预措施，以预防晚年抑郁症的不良后果。为了最大限度地发挥我们的影响力，我们将在大多数抑郁老年人接受护理（初级护理）的环境中以及为有特殊临床（残疾）和社会需求（贫困）的老年人提供服务的环境中开展工作。为了缩短从发现到实践的道路，我们计划在社区中并与社区合作伙伴一起完成大部分工作。 我们的社区合作伙伴将是威彻斯特老年心理健康联盟，该联盟由与我们有着共同担忧的医疗机构、社区心理健康诊所、家庭保健机构、康复医院和政府组织组成。我们建议将威彻斯特县用作新型干预措施的“孵化器”，我们将在国家层面进一步测试这些干预措施，以确定其公共卫生意义。 我们有信心能够应对这项工作的挑战，因为： 1. 我们在将研究、方法论、社区和培训活动整合到一个有凝聚力、无缝工作的系统中的组织经验； 2. 我们的伦理、科学和后勤支持以及员工培训的研究结构； 3. 我们在与社区机构建立持续伙伴关系并向其学习方面的“专业知识”、历史和明确计划； 4. 我们在研究方法开发方面的专业知识； 5. 我们在促进新研究人员发展方面的记录和承诺，这将继续振兴我们的领域。该应用提出了一种研究开发模式，可以快速将临床、社会心理和生物学发现转化为个性化干预措施，缩短从发现到社区实践的路程，使许多抑郁的老年人受益，包括那些被传统研究忽视的患有严重病理和资源有限的老年人。