Claude D. Pepper Older Americans Independence Center at*

描述（由申请人提供）：耶鲁大学OAIC活动将集中在多因素老年健康状况-老年人中常见的健康状况，由多种因素的组合导致，可以通过多因素干预预防，并引发多种可能的结果。在OAIC支持的前几个时期奠定的基础上，我们将重点确定阻碍更全面地了解多因素老年疾病的病因，预防，治疗和结局的障碍的解决方案。我们建议的产品组合包括： 1)从老年综合征模型的新视角调查传统疾病实体，如复发性MI和肺炎; 2）方法学项目，通过开发纵向方法来分析突发事件对结果的影响，并处理常见的双向性，将我们的流行病学和干预研究提升到新的复杂水平（反馈回路）之间的风险因素或治疗和结果和方法，用于确定多因素干预策略的作用机制; 3）现有技术的新应用，如地理信息系统，以评估多因素干预的真实的世界实施的渗透和有效性; 4）对多个领域的新的和现有的测量方法进行分类、分析和传播，供所有OAIC的调查人员使用; 5）探索性项目，如制定一项战略，在面临多因素老年健康状况时，引出老年人的治疗目标;（六）利用意料之外的研究机会，鼓励潜在的转化研究，例如拟议的试点项目，氧化应激反应与人类衰老的关系。最后一个项目特别令人兴奋，因为在细胞水平上指导这项工作的范式与在人类水平上指导耶鲁OAIC工作的范式平行，从而为多因素老年健康状况的病因学，预防和治疗提供了突破性发现的希望。 为了支持这些和其他项目，耶鲁大学OAIC将包括以下核心：1）生物统计学2）数据管理/信息学3）领域核心4）研究职业发展，这将提供早期职业，过渡职业和附属教师，发展奖。

DESCRIPTION (provided by applicant): 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 MI 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 OAICs; 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) Biostatistics 2) Data Management/lnformatics 3) Field Core 4) research career development which will offer early career, transitional career, and affiliated faculty, Development awards.