Brain Aging and Mental Health
Davangere P. Devanand, MBBS
Area Leader, Brain Aging and Mental Health
Bret Rutherford, MD
Area Leader, Brain Aging and Mental Health
The mission of this area is to better understand the causes of later-life neuropsychiatric disorders in order to develop improved treatment and prevention strategies that maximize the functioning and active health span of older adults. Two major divisions, along with their linked research clinics, are responsible for undertaking the cutting-edge research necessary to fulfill this mission. In addition, Brain Aging and Mental Health maintains a broad educational program to provide geriatrics and aging training for medical students, residents, and fellows. Vagelos College of Physicians and Surgeons medical students rotate electively through the research clinics and other sites, while all Columbia/New York State Psychiatric Institute psychiatry residents undertake a one-month rotation through the components of Brain Aging and Mental Health. An Accreditation Council for Graduate Medical Education (ACGME) approved Clinical Fellowship in Geriatric Psychiatry at Columbia University and the NYS Office of Mental Health (OMH) facilities in upstate New York is supported by NY State OMH and directed by Mark Nathanson, MD. Specialized research training in geriatric psychiatry and brain aging is provided to postdoctoral fellows through an NIMH T-32 training grant directed by Steven Roose, MD.
- To promote healthy neuropsychiatric aging trajectories across the lifespan and develop early identification and intervention strategies for individuals at risk of unhealthy aging trajectories
- To understand the causes and pathologic mechanisms of later life neuropsychiatric disorders, such as late life depression, Alzheimer’s disease, and Alzheimer’s disease related dementias
- Based on an understanding of disease mechanisms and clinical experience, to develop novel treatments and prevention strategies for these disorders and target them to specific patient subgroups likely to respond
- To increase interest in aging and mental health and provide outstanding training to the next generation of geriatric psychiatrists and aging researchers
This program performs studies of healthy controls, mild cognitive impairment, and Alzheimer’s disease with a focus on improving diagnosis, biomarkers, and treatment strategies. More specifically, this program conducts studies to treat mild cognitive impairment, agitation and psychosis in Alzheimer’s disease, in addition to an anti-viral treatment study for those diagnosed with early Alzheimer’s disease. These studies, funded by NIH, are led by Davangere P. Devanand, MBBS, MD, with Dr. Terry Goldberg, PhD, Edward Huey, MD, Greg Pelton, MD, Karen Bell, MD, Nancy Kerner, MD, Deborah Deliyannides, MD, and William Kriesl, MD, also working on these projects.
The guiding premise underlying research in this program, led by Bret Rutherford, MD, is that the phenomenology, pathophysiology, and long-term trajectory of a given psychiatric disorder may significantly differ when the disorder occurs in an older adult compared to a younger adult. Aging-associated processes may cause, worsen, or influence the treatment responsivity of neuropsychiatric disorders by means of adverse effects on the structure and function of brain systems. Investigators seek to understand the complex interplay between these aging-related processes and the pathophysiology underlying psychiatric disorders by studying: (1) the etiology and pathophysiology of late life mental disorders; (2) the relationships between physiologic processes associated with aging and the development of late life neuropsychiatric disorders; and (3) the prevention and treatment of late life disorders using novel pharmacologic, somatic, or psychotherapeutic treatments. Our faculty utilize numerous interdisciplinary collaborations to develop a deeper understanding of the physiologic processes accompanying normal aging and distinguish them from the signs and symptoms observed in late life neuropsychiatric disorders. Of particular interest are aging-related processes that have protective effects on the structure and function of brain structures in order to promote healthy aging across the lifespan.
The primary clinical site for geriatric psychiatry projects is the Memory Disorders Center (MDC), which is staffed by a team of neurologists, psychiatrists, neuropsychologists, and other healthcare professionals specially trained in diagnosing and treating memory disorders. Studies conducted in the MDC include investigational treatment studies for mild cognitive impairment and Alzheimer's disease, brain imaging studies utilizing magnetic resonance imaging (MRI) and positron emission tomography (PET) scanning with state-of-the-art techniques and new radioactive tracers, genetic and family studies involving specific risk factors, and new approaches to make an early diagnosis of Alzheimer's disease. Studies of older healthy controls are also ongoing and recruiting participants. The interface between psychopathology and cognitive disorders is another key research focus with diagnostic, investigational and therapeutic strategies for these difficult-to-treat conditions. The MDC is a clinical component of the Columbia University Alzheimer's Disease Research Center (ADRC), which is one of 32 specialized ADRCs funded by the NIA.
The CAAM is directed by Patrick J. Brown, PhD, and specializes in the cognitive, psychiatric, and physical assessment of older adults as well as the pharmacological treatment of late life disorders. Despite its name, studies in the CAAM encompass far more than late life depression. Ongoing studies include an assessment and intervention study for frailty in older adults, longitudinal follow up studies of memory problems in older adults, and several protocols involving the comprehensive assessment of healthy older adults.