$10 million grant to Weill Cornell Institute from NIMH to study geriatric depression

Funding is 1 of National Institute of Mental Health's largest grants given to study depression later in life

The Weill Cornell Institute of Geriatric Psychiatry at NewYork-Presbyterian Hospital/Westchester Division announced today it has received the largest grant in its 20-year history. One of a handful awarded nationally, the new $10 million, five-year "Center Grant" from the National Institute of Mental Health (NIMH) will enable NewYork-Presbyterian/Weill Cornell investigators to advance their pioneering work in understanding the biological, medical, cognitive and psychosocial problems of depressed seniors. The grant is one of the largest ever given by NIMH to study geriatric depression.

The grant's principal investigator is Dr. George Alexopoulos, founder and director of the Weill Cornell Institute of Geriatric Psychiatry at NewYork-Presbyterian/Westchester, professor of psychiatry at Weill Cornell Medical College and director of the NIMH-supported Advanced Center for Interventions and Services Research (ACISR) in late-life depression. He is recognized as one of the world's leading geriatric psychiatry researchers in late-life depression and its treatment.

Dr. Alexopoulos, who has spent his career of more than 30 years investigating late-life depression, said, "To receive a Center Grant by NIMH, a team must have a critical mass of competitively-funded research projects and demonstrate that the Center's new projects and structures will result in a scientific product that will be greater than the sum of its individual projects. As such, the Center Grant represents an endorsement by NIMH of the scope and importance of our team's work."

He added: "This is an exciting time in the history of the Weill Cornell Institute of Geriatric Psychiatry. The 'Center Grant' is significant because it will enable our investigators to synthesize their findings in a meaningful way and develop new tools and practices needed to reduce the burden of depression and disability in elderly persons who have limited access to quality care."

As in the past, the Institute will seek individuals over the age of 60 from the community to participate in research studies.

Since its inception in 1994, the Weill Cornell Institute of Geriatric Psychiatry has consistently received support by NIMH. This is the fourth and largest Center Grant awarded to the Institute since its inception.

Dr. Alexopoulos noted that the Institute demonstrated in its grant application that "we have the infrastructure and unique mix of innovative findings and synergies in place to take our research to the next level by developing new treatments and improving the care offered to elderly patients in the community."

The research efforts of Weill Cornell Institute's team of 13 NIMH-funded investigators, five at the full professor's level, have concentrated in three interrelated core areas:

1. The Biology of Depression -- Studies in this area examine how medical and neurological illnesses may cause depression in some people and how the abnormalities in specific brain circuits may change the course of depression and influence patients' response to antidepressants.

2. Treatment Development -- This work is based on the identification of behavioral limitations and disabilities that increase stress and promote depression in older persons. Developing behavioral treatments that target and mitigate these limitations may improve depression and quality of life.
3. Treatment Implementation -- A set of studies focuses on ways to overcome barriers to depression care in the community. An example of the Institute's approach is a project that connects primary care physicians with mental health clinics so that they deliver a comprehensive care program for depression of older adults. Another project trains home care nurses on various sites across the country to recognize signs of depression and initiate treatment intervention.

Dr. Alexopoulous emphasized the urgency of increasing Weill Cornell's research efforts. "The elderly population is growing exponentially. We expect a 73 percent increase in the number of older adults between now and 2020. Predictably, 15 percent will develop clinical depression. We now know that depressed older persons are much more likely to have worse outcomes when they develop coronary artery disease, cancer and stroke and even die from their complications. Depression in younger adults is painful. In late life, depression is also fatal. Therefore, improving the quality of treatment for geriatric depression has direct implications for the overall care of the older person. For this reason, research in geriatric depression is emerging as a national priority."

Along with its original research, the Weill Cornell Institute of Geriatric Psychiatry has a strong record in training new investigators in late-life depression. A large percentage of its research fellows proceeded to receive competitive NIMH Career Development Awards and to make important contributions to the field of late-life depression.

"The good news is that medication, psychotherapy or combinations of both can improve the depression of more than 50 percent of older adults. I expect that this grant will enable us to improve the available treatments and increase the percentage of patients who benefit from them. In collaboration with our community partners at the Westchester Geriatric Mental Health Coalition, I hope that we will improve the recognition and diagnosis of depression in our County and elsewhere in the country and enable community based services to offer state of the art treatment to large numbers of depressed older persons," Dr. Alexopoulos explained.

The coalition comprises the County Department of Mental Health, the County Department of Senior Programs and Services, community-based primary care practices, social services, rehabilitation hospitals, and home healthcare agencies.