Geriatrics and
Gerontology/Stroud Center
Barry J. Gurland, M.D., Chief
of Psychiatric Research
Jeanne Teresi, Ed.D., Ph.D., Research
Scientist V
John A. Toner, Ed.D., M.Phil., Research
Scientist V
The department is an integral part of the Stroud Center for Studies of Quality of Life, endowed by a bequest from the late Dr. Morris W. Stroud, III. In addition to the Stroud Program, the Center is host to the Statewide Geriatric Psychiatry Residency and Fellowship Programs, the Geriatric Education Center, and a range of research, education, and clinical model development activities.
A main theme of the Center's research deals with changes over time in qualities of life accompanying the mental health problems of aging, with particular attention to the effects of co-morbid medical conditions and ethno-racial influences. Research approaches involve large scale epidemiological studies of a comprehensive range of qualities of life among elders living at home and in congregate sites, and smaller scale clinical and laboratory investigations of specific qualities of life. The clinical relevance of subsyndromal conditions is reconsidered in the light of evidence of their impacting quality of life. A search is made for the relief of impaired qualities of life through service improvements and selected interventions.
Research Projects on Mental Health and Quality of Life
Active Life Expectancy Among Urban Minority Elders (ALE) (Dr. Rafael Lantigua, Principal Investigator; Dr. David Wilder, Co-Principal Investigator; Drs. Gurland and Katz, Co-Investigators). This project, funded by the National Institute on Aging, in collaboration with the Division of General Medicine and the Sergievsky Center, completed its sixth and final year of a study of transitions in function among elders in North Manhattan. Ethno-racial differences in active life expectancy have been identified, and the influence of health insurance on use of personal care services have been demonstrated. Secondary analysis of these data has continued.
Matching Time Patterns of Need and Home Care Services: A Unique Client-Centered Approach to Home Care Service Improvement. The principal aim of this project, which is funded by the Fan Fox and Leslie Samuels Foundation, is to direct the attention of home-care providers, managers, and hands-on staff to time-related aspects of assisted activity as an effective means of increasing awareness of quality of life issues in general. An additional aim of the project is to improve the quality of life of home-care clients through increased staff awareness of quality of life issues and client specific quality of life information. Follow-up interviews were completed in April, 2000, and data analysis will continue through June 2001.
During 2000, work on the development of the Feeling-Tone Questionnaire (FTQ) and its psychometric properties has continued under the direction of Dr. John Toner, with the FTQ being used in a national multi-site study of special care units for the demented. FTQ data are currently being analyzed from over 400 nursing home subjects residing in upstate New York and 116 subjects residing in New York City nursing homes.
Training Programs in Geriatric Research
New York Statewide Geriatric Psychiatry Residency and Fellowship Program. This ACGME-accredited program is co-directed by Drs. Peter Birkett and John Toner and supported by the New York State Office of Mental Health. It consists of two major components: education and research, organized around a geriatric psychiatry residency/fellowship at Binghamton and Middletown Psychiatric Centers in upstate New York, with monthly rotations at New York and Presbyterian Hospitals. The program focuses on preparing psychiatrists in the practice of geriatric psychiatry related to the transition of the public mental health system from a concentration on inpatients to integrated hospital and community mental health sites of service. Current research activities include: a cross national collaborative project on community reinvestment in New York State and the United Kingdom, studies of the diagnosis of depression and dementia in the non-communicating elderly, the development of a culturally-sensative approach to facilitating help-seeking behaviors among depressed minority elders, a longitudinal study of outcomes related to DNR orders in nursing homes, a study of late-onset mania in elderly outpatients, and a study neuroleptic sensitivity in elderly mentally ill patients. Additional studies focus on causes of agitated behaviors in dementia, psychiatric differences between vascular and organic brain disorders, and a 10-year retrospective autopsy study of cerebral arteriosclerosis.
The Columbia Center for the Active Life of Minority Elders (CALME). This resource center in aging research at Columbia has begun its fourth year of operation and is the only federally funded center on the east coast for minority aging-related research. CALME is funded by the National Institute on Aging and the National Institute of Nursing Research. Its focus is on health-related quality of life ranging from diabetes and heart disease to depression and Alzheimer's. Rafael Lantigua, M.D., Professor of Medicine at Columbia University College of Physicians & Surgeons, is the director of CALME; Barry Gurland, M.D., the Sidney Katz Professor and Director of the Stroud Center, is the co-director.
The center's main goal is to provide opportunity, support, and guidance for young minority researchers interested in the field of aging. During 2000, Dr. Enoch Barrios, a resident in the Statewide Geriatric Psychiatry Residency and Fellowship Program at the Stroud Center, completed his CALME research on help-seeking behaviors in depressed minority elders. This research was conducted under the mentorship of Drs. Barry Gurland and John Toner and supported with funds from the CALME junior investigator development award.
Columbia UniversityNew York Geriatric Education Center. The extended application is under the direction of Dr. Terry Fulmer, with Co-directors Dr. Barry Gurland and John Toner from Columbia University, Dr. Mathy Mezey from New York University, Dr. Christine Cassel from Mt. Sinai Medical Center, and Dr. Robert Kennedy from Beth Abraham Hospital. The project recently began its first year of five years of continuation funding by the National Institute of Aging. The continuation GEC builds upon the work begun in the initial three-year funded program (1994-1997) and adds to it a focus on quality of life. It includes lectures and practicums on geropsychiatry, clinical practice and quality of life improvement, geriatric assessment, communication issues, elder mistreatment, nutrition, bioethics, Alzheimer's disease, interdisciplinary team training, and quality of life. During 2000, Dr. John Toner developed and implemented the GEC Geriatric Scholars Certificate Program in Binghamton in collaboration with Binghamton Psychiatric Center, SUNY- Binghamton Clinical Campus and United Health Services Hospitals' Center for Healthy Aging. The program involves the resident/fellows from the Statewide Geriatric Psychiatry Residency and Fellowship program in the teaching activities of the GEC.
Research Information Transfer on Quality of Life in Aging
Quality of Life Assessment in Health and Aging Seminar (P6218). This seminar is sponsored by the Stroud Program as part of an effort to foster quality of life research, including its applications to mental health and disorders. The course is currently taught by Drs. Gurland and Cecile Yancu in collaboration with the School of Public Health.
Overview of Geriatrics and Gerontology (PHP 6230). This course is taught by Dr. John Toner in collaboration with the School of Public Health and the Columbia University Statewide Geriatric Psychiatry Residency and Fellowship Programs. Other faculty of the Stroud Center participate as guest lecturers. The course provides an introduction to and overview of the process of aging with special emphasis given to the review of theoretical perspectives and research on such topics as demography and epidemiology of aging as well as biological, medical, psychological, psychiatric, social, and environmental factors that influence the aging process. The course also serves as a learning/teaching laboratory for residents and fellows of the Statewide Geriatric Psychiatry Residency and Fellowship Programs.
Overview of Long Term Care (PHP 6240).
This course is taught by Dr. John Toner in collaboration with the School
of Public Health and reviews the wide range of health and supportive services
in the continuum of long term care. A major emphasis of the course is
the development of community programs and services for the chronically
mentally ill elderly. Residents of the Statewide Geriatric Psychiatry
Residency and Fellowship Program participate in lectures and field visits.
From left to right, Dr. John
Toner, Dr. Barry Gurland, Dr. David Wilder,
Dr. Brian Rosenthal, Ms. Lorraine Borrero, and Dr. Cecile Yancu