Cornell ACISR for Late Life Depression

描述（由申请人提供）：拟议中的高级干预和服务研究中心（ACISR）的使命是产生和传播旨在减轻老年人抑郁和残疾负担的知识和实践，促进研究人员的成长，并推进未来开展这项工作所需的方法。老年人的迅速增加（预计到2020年美国将增加73%）以及使他们的护理复杂化的多种疾病和残疾使老年研究成为国家的优先事项。我们关注晚年抑郁症，因为它对老年人的健康造成巨大影响。抑郁症是导致残疾的主要原因，并造成医疗发病率、死亡率、个人痛苦、家庭破裂和护理费用。我们努力了解老年人抑郁症的生物学、医学、认知和社会心理问题，并利用这些知识开发针对他们复杂临床问题的干预措施。与此同时，我们的目标是患者接受和坚持治疗，以及提供者和系统层面的护理障碍，这些障碍使大多数抑郁症老年人得不到治疗，残疾和痛苦。我们相信，我们的中心已经成为研究这一基本上被忽视的人口的全国性资源。我们的主要优势是拥有一个具有互补技能的和谐工作团队和一个在概念、方法和研究实施层面促进协同作用的研究组织。我们为我们在同行评议出版物、联邦拨款、职业发展、培训项目和社区外展方面的记录感到自豪。ACISR将为我们提供机会继续我们的疗效研究，并进一步加强我们的有效性和实践研究，以便我们能够增加循证护理的影响。我们的合作伙伴将是威彻斯特老年项目和服务部（WDSPS），这是一个县组织，负责实施我们社区老年人社会支持和维持的大多数项目。我们期望这种伙伴关系将我们的干预措施带到社区机构，那里为大多数抑郁的老年人提供服务。我们建议把威彻斯特县作为一个“实验室”，在那里我们将研究在社区范围内提供有效的治疗方法。我们相信，我们的工作将促进科学知识的发展，并对抑郁症、残疾老年人的护理产生广泛影响。

DESCRIPTION (provided by applicant): The mission of the proposed Advanced Center for Interventions and Services Research (ACISR) is to produce and disseminate knowledge and practices aiming to reduce the burden of depression and disability in older persons, promote the growth of investigators, and advance the methodology needed to carry this work into the future. The rapid increase of older persons (73% increase is anticipated in US by year 2020) and the multiple diseases and disabilities complicating their care make geriatric research a national priority. We focus on late-life depression because of its overwhelming consequences on the health of older persons. Depression is the leading cause of disability and contributes to medical morbidity, mortality, personal suffering, family disruption, and the cost of care. We have worked to understand the biological, medical, cognitive, and psychosocial problems of depressed elders and use this knowledge to develop interventions designed for their complex clinical problems. At the same time, we target patient acceptance and adherence to treatment, as well as barriers to care at the provider and the system level, which leave the majority of depressed elders under-treated, disabled, and suffering. We believe that our Center has become a national resource for studies of this largely neglected population. Our main strengths have been the assembly of a harmoniously working team with complementary skills and a research organization that promotes synergy at the conceptual, methodological, and research implementation levels. We are proud of our record in peer-reviewed publications, federal grants, career development, training programs, and community outreach. The ACISR will offer us the opportunity to continue our efficacy studies and further strengthen our effectiveness and practice research, so that we can increase the impact of evidence-based care. Our partner will be the Westchester Department of Senior Programs and Services (WDSPS), the County organization that implements most programs for social support and sustenance of older persons in our community. We expect this partnership to bring our interventions to community agencies, where most depressed elders are served. We propose to use Westchester County as a "laboratory" in which we will study the delivery of efficacious treatments on a community-wide basis. We are confident that our work will both advance scientific knowledge and have a broad impact on the care of depressed, disabled elders.