Background: Depression in older adults often proves challenging to treat, with up to 50% not responding to initial antidepressant therapy and fewer than 20% achieving remission. Utilizing a robust multi-site clinical trial network, we have conducted two landmark randomized controlled trials (RCTs) that demonstrated the efficacy of augmenting antidepressant treatment with aripiprazole (ARI) or bupropion (BUP). These interventions achieved a 29% remission rate in treatment-resistant late-life depression (TRLLD). 

Objective: Building on the findings of the OPTIMUM and OPT-NEURO studies, we aim to advance the BAARD study whos primary objective is to improve treatment selection for late-life depression (LLD) by leveraging precision biomedical information. 

Data Integration and Analysis: The BAARD initiative seeks to develop a clinical decision support tool to enhance treatment selection for TRLLD. This effort integrates diverse expertise, including geroscience, psychopharmacology, cognition, molecular subtyping, neuroimaging, computational psychiatry, and qualitative research methodologies. 

Significance: To achieve these goals, we will utilize comprehensive demographic, clinical, cognitive, genetic, proteomic, and neuroimaging data from approximately 700 participants. The development and testing of the BAARD tool aim to significantly improve remission rates and transform care delivery for this vulnerable population.

​​Collaborating Institutions: The BAARD project is an international research initiative that leverages multi-modal data - encompassing clinical assessments, neuroimaging, biomarkers, and genomics - through the collaboration of leading institutions including Washington University, Columbia University, UCLA, University of Pittsburgh, and CAMH.

Link to NIH Project details:  1UG3MH137353-01