Project Summary: Overall OAIC The UCSF OAIC theme is “Predictors, Outcomes, and Amelioration of Late-life Disability: A Focus on Vulnerable Populations.” The UCSF OAIC has supported an interdisciplinary community of investigators whose discoveries have enhanced our understanding of disability, especially in those with medical and social vulnerabilities. Our OAIC conceptualizes vulnerability as a complex interplay of both medical vulnerability and social vulnerability, and we have demonstrated that medical and social vulnerabilities are inextricably linked. The OAIC has been a galvanizing force at UCSF, forging alliances with other UCSF centers. We have applied core geriatric concepts to vulnerable older adults in a wide range of disciplines such as oncology and surgery. Our work on the interaction of social and medical vulnerability has led to a better understanding of how to address the needs of older adults who have low literacy, are homeless, or are incarcerated. Our dedication to mentoring has led to many GEMSSTAR and Beeson Awards. During the next cycle we will build on our track record, supporting career scholars and pilot awardees who are engaged in innovative projects that focus on older persons’ complex medical and/or social vulnerabilities. We will continue to identify factors that increase the risk of developing disability and that adversely affect quality of life of disabled older adults, and we will develop strategies to improve these outcomes. Our two resource cores will catalyze a wide spectrum of clinical and outcomes research. Our Data and Analysis Core will facilitate the use of high quality data sources that are particularly useful for disability research in vulnerable older persons and will provide statistical consultation. Our Vulnerable Aging Recruitment and Retention Core will support new research among older populations that are traditionally difficult to enroll and retain in studies, building on the capacity we have developed to engage homebound, cognitively impaired, homeless, and low- literacy older adults as well as elders in nursing homes, safety net hospitals, and correctional facilities. The overriding goal of UCSF’s OAIC is to foster a mission-driven culture of excellence grounded in a commitment to improving quality of life for vulnerable older adults with or at risk for disability. We have 5 aims: 1. Catalyze research on disability in vulnerable older persons at UCSF by serving as a hub that brings together scholars and leverages resources. 2. Provide core access to data resources, statistical support, and expertise enrolling and retaining vulnerable older subjects in order to stimulate new research on disability. 3. Support pilot studies that accelerate science and lead to research funding in late life disability. 4. Identify future leaders of aging research and support them with career development funding and mentoring. 5. Develop a leadership and administrative structure that spurs interdisciplinary collaboration, making the OAIC greater than the sum of its parts.

PROJECT NARRATIVE – Overall UCSF Older Americans Independence Center (OAIC) The UCSF OAIC theme is “Predictors, Outcomes, and Amelioration of Late-life Disability: A Focus on Vulnerable Populations.” We support research that will lower the burden of disability, either through preventing or delaying it, or reducing its impact on quality of life (amelioration). We have a focus on older persons who are vulnerable, either due to medical or social reasons.