Mentoring Researchers in Prognosis Research in Alzheimer’s Disease and Related Dementias
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PROJECT ABSTRACT Prognosis is critical to individualizing decision making for older adults. Our research program has included 3 R01 awards focused on developing and externally validating prognostic models for individualizing decision- making. We disseminate our prognostic models in high impact publication and via ePrognosis, our free, easy to use online compendium of prognostic indices (average15,000 uses/month). Additionally, our models can be embedded into electronic health records (EHRs). Our current R01 is focused on developing prognostic models for 6-month and 2-year mortality in hospitalized older adults (age 50+) with and without Alzheimer’s Disease and Related Dementias (ADRD). The object of this K24 renewal is to use the novel multisite 4-health system, 5 state EHR dataset of hospitalized older adults we assembled for our R01 to mentor trainees to develop prognostic models for non-mortality outcomes that are important to older adults, clinicians, and health systems: delirium, falls, mobility, length of stay, and likely discharge location. The research aims of this proposal are: (1) To develop and externally validate prognostic models that predict outcomes that occur during hospitalization for older adults with and without ADRD: (1) delirium; and (2) falls; and (2) To develop and externally validate prognostic models that predict outcomes at hospital discharge for older adults with and without ADRD: (1) mobility function; (2) length of stay; and (3) likely discharge location. The proposed research provides an outstanding platform for mentees to learn about prognostic modeling, measurement issues, validation, transportability, traditional modeling vs machine learning approaches, Age Friendly Health Systems, and ADRD-research. My mentees often start as research fellows in the T32 Aging Research Training program for which I serve as Director. During the initial K24 period I assumed the role of Director for the UCSF Division of Geriatrics T32 in Aging Research, published 27 manuscripts in high profile journals as senior author with a mentee in the first author role, served as primary mentor on ten K76, K23, K01, and KL2 awards, and helped four of my mentees transition from K to R with a first time R01-level award. The career goals of this K24 renewal, which synergize with the research aims, are: (1) To expand my mentoring skills and reach, with a particular focus on mentoring investigators in patient-oriented aging research from disciplines other than geriatrics, with a focus on palliative care; (2) To improving my skills at developing and leading large scale mentoring programs; and (3) To developing skills around methods in delirium, falls, and mobility that will expand my ability to conduct high-impact patient-oriented aging research.
