Nunzio Pomara, M.D., Program Director
John J. Sidtis, Ph.D., Research Scientist
Web site: http://geri.rfmh.org/

The Geriatric Psychiatry Research Division is under the direction of Nunzio Pomara, M.D., who is also a professor of Psychiatry at the New York University School of Medicine. The division includes a staff of clinical and experimental research scientists at NKI with expertise in diverse aging-related health issues. The focus of our research is identifying adverse cognitive changes associated with normal brain aging, Alzheimer's disease, other neurobehavioral disorders, commonly prescribed psychotropic agents, and evaluating the efficacy and safety of novel pharmacological agents for the treatment of Alzheimer's disease in three core programs:

• Memory Education and Research Initiative (MERI)
• Geriatric Psychopharmacology Research Program
• Brain and Behavior Research Program

Memory Education and Research Initiative (MERI)

The early detection of cognitive problems in older adults plays a critical role in the implementation of appropriate management and therapeutic treatments. In order to facilitate the early detection process, we have established the Memory Education and Research Initiative (MERI), in collaboration with the Rockland County Department of Health, which offers free neuropsychological evaluations to local residents. The goals of the MERI are to:

• Alert community physicians and psychologists about ongoing clinical studies.
• Make neuropsychological and psychiatric evaluations available to local residents.
• Communicate study results to patients and clinicians in the community.
• Develop advanced neuroimaging techniques for clinical memory studies.
• Bring basic science findings to the clinic.
• Serve as an educational resource for the patients and clinicians in the community.

Geriatric Psychopharmacology Research Program

The Geriatric Psychopharmacology Research Program focuses on the identification of potential cognitive toxicity associated with commonly prescribed psychotropic medications (those which act on the mind) in the elderly. It also seeks to identify pharmacokinetic and genetic mechanisms that may contribute both to the increased sensitivity of drug-induced cognitive toxicity in elderly persons and to individual susceptibility to these adverse effects. Current research studies are designed to investigate the following in the elderly:

• Determine whether tolerance to the acute adverse performance effects of the benzodiazepine lorazepam develops in elderly individuals on long-term treatment with this medication.
• Examine whether the adverse effects of anticholinergic medications are modified by genetic and other behavioral markers for Alzheimer's disease.
• Examine the relationship between possible reductions in plasma amyloid-beta during longitudinal follow-up and cognitive decline.
• Identify genetic and other behavioral markers that predict cognitive decline consistent with Alzheimer's disease.

Ongoing experimental approaches for the treatment of Alzheimer's disease are also a major part of the Geriatric Psychopharmacology Research Program. The current FDA approved treatments for this condition have limited efficacy. We are currently participating in a number of clinical trials sponsored by various pharmaceutical companies to evaluate the safety and efficacy of the following pharmacological agents for their value as cognitive enhancers or ability to slow disease progression in patients with Alzheimer's dementia:

• Memantine: This drug, recently approved by the FDA for the treatment of moderate to severe Alzheimer's disease has been available since Jan 2004. This study is evaluating the long-term efficacy of Memantine in mild to moderate Alzheimer's disease.
• Neramexane: TNeramexane is a drug similar to memantine. This is a 24-week, double-blind, randomized, placebo-controlled study examining the effectiveness and safety of neramexane in patients with moderate to severe Alzheimer's disease.
• Insulin-like Growth Factor-1 (IGF-1):: This multicenter double-blind, placebo-controlled Phase II study is testing the safety and efficacy of MK-0677, a substance which stimulates growth hormone secretion, in slowing the progression of AD.

Brain and Behavior Research Program

The Brain and Behavior Research Program is aimed at developing multidisciplinary clinical studies by integrating behavioral, pathophysiological, pharmacological, neuroimaging, and, when appropriate, genetic approaches to the study of brain-behavior relationships. Studies of neurobehavioral disorders will examine the effects of specific pharmacological therapies and specific biological markers on the severity of cognitive disorder in individuals at risk for developing AD. A second set of studies is examining the brain areas involved in the motor control of speech. Speech is affected by a range of degenerative diseases and a number of medications. Equally important, some of the brain areas involved in speech are also involved in a number of neurobehavioral disorders; understanding their function will have widespread applications. These studies will allow us to:

• Better understand how specific brain areas interact during different behaviors.
• Develop more sensitive methods to detect abnormalities in brain function.
• Design more sensitive clinical trials to evaluate the effectiveness of new therapies.

For further information, contact Dr. Pomara by telephone at (845) 398-5579 or by email at