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Clinical Trials: Psychiatry - Geriatric/Older Adults
IRB No. 17-021S-1 (Dr. Richard Fortinsky, PI): Care Management for Cognitively Vulnerable Older Adults
The purpose of the study is to compare ways to support the health of people over age 65 who may be experiencing signs of memory problems, feelings of sadness, or feelings of confusion. The study will look at how nurses, social workers and other health care professionals can help older adults get the care they need and to stay as healthy as possible. This type of support provided by these healthcare professionals is called "care management services". The study will compare two different care management teams: "Home Based Care Team" and "Telephone Based Care Team". The "Home Based Care Team" (HBCT) is composed of a nurse practitioner who is specifically trained to provide care and psychosocial support to older adults, social worker, physical and occupational therapists, registered dietician, pharmacist and community health educator. The Home Based Care Team nurse practitioner will lead this care management team. Interaction with the team will primarily take place within the older adult's home. The "Telephone Based Care Team" (TBCT) is composed of a nurse care manager who will assess the older adult's current health status and provide referrals to other healthcare professionals as needed. Interaction with the "Telephone Based Care Team" will primarily take place over the phone.
IRB No. 19-214-1 (Dr. David Steffens, PI): Apathy and Reward Systems in Alzheimer's Disease
Apathy is a common feature of Alzheimer's disease (AD) that is related to functional decline, but its underlying neurobiology is poorly understood. In this application, we propose to use functional magnetic imaging and tasks that focus on the brain's reward system to examine apathy in AD and in late-life depression. Our aim is to identify new targets for intervention to improve apathy in patients with AD.
IRB No. 20-122-1 (Dr. Lihong Wang, PI): A Neural Study of the Maturational Shift in Emotion Regulation in Healthy Aging and Depression
This study will focus on examining the impacts of age and depression history on emotion regulation, both behaviorally and neurally. Maladaptive emotion regulation in older subjects with a history of depression is a risk for depression relapse. Confirming the failure in the normal adult maturational shift in emotion regulation in remitted depressed patients and identifying neural mechanisms supporting emotion regulation strategies used in remitted depressed subjects will inform the future development of novel prevention or treatment interventions.
IRB No. 20-105-2: Apathy and Biomarkers of Cognitive Decline in Depression Study
This research is being done to determine if older adults who are experiencing depression and/or apathy (decreased motivation) are at increased risk of developing cognitive decline and Alzheimer';s disease. The purpose of this research study is to try and find a better way to diagnosis cognitive decline and/or Alzheimer';s disease in older adults. Diagnosing Alzheimer';s disease or cognitive decline is complex. With no single test currently available, diagnosis is based on an individual';s history, physical examination, and cognitive testing. With the information gathered from a lumbar puncture (or spinal tap) and subsequent analysis of the fluid obtained from the procedure, we may improve our ability to detect brain changes associated with Alzheimer';s disease well before a person begins to experience significant cognitive decline (or dementia).
IRB No. 21-046-2 (Dr. Kevin Manning, PI): Cognitive Remediation of Cognitive Control in Late-Life Depression
This research is being completed because depressed older adults commonly experience difficulties with concentration and processing speed, also called executive dysfunction, as well as negative affect/emotions (e.g., low mood, irritability, worry). Older adults with depression and executive dysfunction and/or negative affect/emotions regularly fail to get better with conventional antidepressant medications. Therefore, the purpose of this study is to use an established non-invasive treatment (computerized brain-training) that may improve cognitive and depression related outcomes in older adults. There are two aims of the current study. We are interested in whether a computerized braintraining treatment will improve thinking and depression in older depressed adults. We are also interested in whether participating in the treatment will result in changes to brain activity measured with magnetic resonance imaging (MRI).
IRB No. 21-257-2 (Dr. Breno Diniz, PI): The SenDep Study: Linking Molecular Senescence Changes to Depression and Cognitive Impairment in Late Life
Late-life depression (LLD) is a common mental disorder in the elderly, with prevalence rates ranging from 1 to 5%. Recent evidence suggests that LLD is linked to age-related negative health outcomes, such as cerebrovascular disease, increased risk of Alzheimer's disease, vascular dementia, and of premature mortality. The mechanisms of LLD are complex and involve the dysregulation of different biological pathways. Understanding the interplay between the biological changes in aging and depression can provide insight into the mechanisms by which LLD increases the risk of negative health outcomes. This study proposes to evaluate the association of Senescence-Associated Secretory Phenotype (SASP) Index with different clinical phenotypes of aging (i.e., cognitive impairment) and with cellular senescence phenotype (i.e., leukocyte telomere [LT] attrition) in LLD. Finally, we will evaluate the trajectory of changes in SASP, and its relationship with cognitive performance in these individuals. Our hypotheses are that LLD individuals will show a significantly higher SASP index compared to age- and gender-matched never-depressed control subjects. SASP index will be significantly associated with greater cognitive impairment and telomere attrition in LLD subjects. We further hypothesize that an increasing or persistently higher SASP index trajectory will lead to faster cognitive decline among study participants over two years of follow-up. To our knowledge, this will be the first study to examine the association between circulating molecular senescence markers (SASP), a cellular senescence marker (LT attrition), and neurocognitive and clinical characteristics in LLD. Based on the results of this study, we will also be able to identify novel targets for the development of interventions aiming not only the treatment of depression in the elderly but also aiming the prevention of the negative outcomes related to this condition