Late Life
The Center's faculty has advanced our understanding of the onset of and treatment for late life depression.
Davangere P. Devanand, MBBS, MD
Dr. Devanand is a professor of psychiatry and neurology, and he serves as director of Geriatric Psychiatry in the Department of Psychiatry at Columbia University Irving Medical Center. He received his medical degree at Christian Medical College, Vellore, India, and completed his psychiatry residency training at S.U.N.Y. Upstate Medical Center in Syracuse, NY, and Yale University School of Medicine. Dr. Devanand has written and co-written three books, and he has authored over 300 peer-reviewed publications. His research helped to define the clinical features and treatment response in elderly patients with dysthymic disorder, a chronic depressive illness. He pioneered studies on the interface between depression and cognitive impairment in the elderly, and he is well-known for his research on early diagnostic markers of Alzheimer’s disease and the treatment of psychosis and agitation in this disorder. He has been principal investigator on research grants from the National Institute of Aging, National Institute of Mental Health, Department of Defense, Alzheimer’s Association, NARSAD, and the Dana Foundation, and has received several awards, including the International Psychogeriatrics Association Research Award, Indo-American Psychiatric Association Distinguished Scientist Award, American Psychiatric Association Jack Weinberg Memorial Award in Geriatric Psychiatry, American Association of Geriatric Psychiatry Distinguished Investigator Award, and American College of Psychiatrists Award for Research in Geriatric Psychiatry.
Current Projects
1. Olfactory Impairment in Offspring Study of Racial Disparities in Alzheimer’s Disease
Grant: R01 AG058767
Role: Principal Investigator
Description: The overarching goal of this project is to identify priority biological or social factors for intervention during the preclinical stage of Alzheimer’s Disease (AD) and determine whether strategies to prevent AD should differ across race/ethnicity. Adding odor identification testing furthers these goals in the existing project and allows for the testing of specific hypotheses that will enhance our understanding of the associations and potential utility of this inexpensive early biomarker of AD.
2. Cognitive Training and Neuroplasticity in Mild Cognitive Impairment
Grant: R01 AG052440
Role: Principal Investigator
Description: This project aims to address three key issues that have not been addressed systematically in a single well-controlled study in Mild Cognitive Impairment (MCI): Does Computerize Cognitive Training (CCT) lead to improved cognitive functioning, do the effects of CCT transfer to functional ability and tasks of everyday life, and does CCT lead to long-term changes in brain networks, e.g., the default mode network using resting fMRI?
3. Anti-viral Therapy in Alzheimer’s Disease
Grant: R01 AG055422
Role: Principal Investigator
Description: This projects marks the first-ever clinical trial to directly address the long-standing viral etiology hypothesis of Alzheimer’s Disease (AD), which posits that viruses, particularly the very common HSV1 and HSV2, may be etiologic or contribute to the pathology of AD.
Recent Publications
Goldberg, T. E., Huey, E. D., & Devanand, D. P. (2020). Association of APOE e2 genotype with Alzheimer's and non-Alzheimer's neurodegenerative pathologies. Nature Communications, 11(1), 4727.
Devanand, D. P., Lee, S., Luchsinger, J. A., Andrews, H., Goldberg, T., Huey, E. D., Schupf, N., Manly, J., Stern, Y., Kreisl, W. C., & Mayeux, R. (2020). Intact global cognitive and olfactory ability predicts lack of transition to dementia. Alzheimer's & Dementia, 16(2), 326-334.
Devanand, D. P., Andrews, H., Kreisl, W. C., Razlighi, Q., Gershon, A., Stern, Y., Mintz, A., Wisniewski, T., Acosta, E., Pollina, J., Katsikoumbas, M., Bell, K. L., Pelton, G. H., Deliyannides, D., Prasad, K. M., & Huey, E. D. (2020). Antiviral therapy: Valacyclovir Treatment of Alzheimer's Disease (VALAD) Trial: protocol for a randomised, double-blind, placebo-controlled, treatment trial. BMJ Open, 10(2), e032112.
Contact
Email: dpd3@cumc.columbia.edu
Phone: 646-774-8658
Office Address: 1051 Riverside Drive, Unit 126, New York, NY 10032
Steven P. Roose, MD
The primary focus of Dr. Roose’s research is the phenomenology, psychobiology, and treatment of affective disorders in depression, particularly in older patients. Initially, his research focused on the relationship between cardiovascular disease and depression as well as the use of antidepressant medications in depressed patients with cardiovascular comorbidities. This work established an evidence base to make decisions about differential therapeutics in depressed patients with cardiovascular problems in addition to providing information about the pathophysiology of this comorbidity. As Dr. Roose’s initial focus expanded, he conducted numerous antidepressant clinical trials for late life depression, including trials of tricyclic agents vs. selective serotonin reuptake inhibitors, and augmentation trials for treatment resistant late life depression. He was the principal investigator on the “old-old” study, a placebo-controlled trial of citalopram in depressed patients with a mean age of 80 years with moderate to severe medical comorbidity. Currently, he is the principal investigator for the Columbia site on the OPTIMUM study, the largest clinical trial of treatment resistant depression ever conducted in people over the age of 60. Another focus of his work has been the development of young researchers. He is the principal investigator of the T-32 in Research Training for Late-Life Neuropsychiatric Disorders and the T-32 Research Training in Mood and Anxiety Disorders: From Animal Models to Patients. He is also the research training director for the Conte Center Administrative Core.
Current Projects
1. Research Training in Mood and Anxiety Disorders
Grant: T32 MH015144
Role: Principal Investigator
Description: The goal of this program is to train young investigators committed to basic and clinical research in affective and related psychiatric disorders.
2. Research Training in Late Life Neuropsychiatric Disorders
Grant: T32 MH020004
Role: Principal Investigator
Description: The goal of this program is to train young investigators committed to basic and clinical research in late life psychiatric disorders.
3. Optimizing Outcomes in Treatment-Resistant Depression in Older Adults (OPTIMUM study)
Grant: PCORI
Role: Site Principal Investigator
Description: The primary goal of this multi-center pragmatic PCORI trial is to provide evidence for the treatment of treatment-resistant depression in older adults, elucidate how aging alters the risk/benefit ratio of antidepressant treatment in this group, and to disseminate this evidence to the stakeholders to offer older adults the optimal treatment they deserve.
Recent Publications
Rutherford, B. R., & Roose, S. P. (2013). A model of placebo response in antidepressant clinical trials. American Journal of Psychiatry, 170(7), 723-733.
Roose, S. P., Rutherford, B. R., Wall, M. M., & Thase, M. E. (2016). Practising evidence-based medicine in an era of high placebo response: number needed to treat reconsidered. British Journal of Psychiatry, 208(5), 416-420.
Roose, S. P., & Rutherford, B. R. (2016). Selective serotonin reuptake inhibitors and operative bleeding risk: A review of the literature. Journal of Clinical Psychopharmacology, 36(6), 704-709
Contact
Email: spr2@cumc.columbia.edu
Phone: 646-774-8661
Office Address: 1051 Riverside Drive, New York, NY 10032
Bret R. Rutherford, MD
Dr. Rutherford graduated from Harvard College and the Columbia University College of Physicians and Surgeons, and then trained in psychiatry at Columbia University. Following residency, he completed a T32 Postdoctoral Fellowship in Affective and Anxiety Disorders at Columbia, and then, received a K23 Career Development Award focused on clarifying the pathophysiology and treatment mechanisms in depression. Currently, Dr. Rutherford is an associate professor of Clinical Psychiatry and co-director of Columbia’s Research Area on Brain Aging and Mental Health. His research seeks to understand the causes of later life neuropsychiatric disorders, elucidate their interactions with biological aging processes, and develop improved treatment and prevention strategies that maximize the functioning and active healthspan of older adults. By elucidating age-related pathophysiologic routes to developing psychiatric illness (e.g., dopaminergic decline leading to psychomotor slowing and late life depression), he hopes to develop age-informed precision interventions as well as methods for identifying and intervening when individuals depart from normative trajectories to restore healthy aging.
Current Projects
1. Dopaminergic Dysfunction in Late Life Depression: The D3 Study
Grant: R01 MH123660
Role: Principal Investigator
Description: This collaborative R01 project characterizes dopaminergic dysfunction in Late Life Depression and determines the degree to which it responds to pharmacologic modulation with levodopa.
2. Mentoring to Develop Aging-Informed Patient-Oriented Research in Neuropsychiatry
Grant: K24 MH122514
Role: Principal Investigator
Description: The goal of this K24 Midcareer Award application is to contribute broadly toward the development and implementation of aging-informed, precision interventions for older adults with neuropsychiatric disorders. Integrated, mutually complementary plans are proposed to: (1) undertake further training in evidence-based decision making, mobility, and exercise interventions, (2) provide mentoring that seeks to remedy the paucity of researchers focused on neuropsychiatric disorders in later life, and (3) conduct new patient-oriented research examining a novel therapeutic strategy for older adults with depression and psychomotor slowing.
3. Neurocognitive and Neuroimaging Biomarkers: Predicting Progression Towards Dementia in Patients with Treatment Resistant Late-Life Depression
Grant: R01 MH114980
Role: Principal Investigator
Description: Leveraging a Patient-Centered Outcomes Research Institute (PCORI)-funded treatment study of N=1500 people with Late Life Depression (LLD) across five sites, this project will comprehensively delineate neurocognitive and neuroimaging biomarkers associated with progression to dementia in people with persistent LLD compared to those whose LLD remit with treatment.
4. Cognitive and Neural Mechanisms of the Accelerated Aging Phenotype in PTSD
Grant: R01 MH111596
Role: Principal Investigator
Description: Chronic PTSD increases mortality risk from medical diseases, promotes aging-associated syndromes such as frailty, and is linked to faster cognitive decline in older adults. This study investigates the interplay between aging processes and PTSD, which may help identify novel therapeutic targets to promote healthier aging trajectories for PTSD patients.
5. Targeting Dopaminergic Mechanisms of Slowing to Improve Late Life Depression
Grant: R61/R33 MH110029
Role: Principal Investigator
Description: This project tests whether administering levodopa to older depressed patients increases striatal dopamine release and increases processing speed and gait speed. Engaging these molecular and functional targets is hypothesized to result in depressive symptom improvement.
6. Sensation and Psychiatry: Linking Age-Related Hearing Loss to Late Life Depression and Cognitive Decline
Grant: R21 AG059130
Role: Principal Investigator
Description: This project tests whether untreated age-related hearing loss (ARHL) represents a distinct pathophysiologic route to developing Late Life Depression (LLD) and whether individuals with comorbid ARHL/LLD are unlikely to respond to treatments (i.e., antidepressant medication) that do not treat the underlying hearing problem.
Recent Publications
Rutherford, B. R., Choi, C. J., Chrisanthopolous, M., Salzman, C., Zhu, C., Montes-Garcia, C., Liu, Y., Brown, P. J., Yehuda, R., Flory, J., Neria, Y., & Roose, S. P. (2021). The COVID-19 pandemic as a traumatic stressor: Mental health responses of older adults with chronic PTSD. The American Journal of Geriatric Psychiatry, 29(2), 105-114.
Rutherford, B. R., Slifstein, M., Chen, C., Abi-Dargham, A., Brown, P. J., Wall, M. W., Vanegas-Arroyave, N., Stern, Y., Bailey, V., Valente, E., & Roose, S. P. (2019). Effects of L-DOPA monotherapy on psychomotor speed and [11C]Raclopride binding in high-risk older adults with depression. Biological Psychiatry, 86(3), 221-229.
Rutherford, B. R., Brewster, K., Golub, J. S., Kim, A. H., & Roose, S. P. (2018). Sensation and psychiatry: Linking age-related hearing loss to late-life depression and cognitive decline. American Journal of Psychiatry, 175(3), 215-224.
Contact
Email: brr8@cumc.columbia.edu
Phone: 646-774-8660
Office Address: 1051 Riverside Drive, Box 98, New York, NY 10032