1. Methodological Issues and Techniques
Dinner Working Group

2. Methodologies for Looking at Domains
Much on Cognition and Movement
Little on emotion and movement
Little on all three together
Little on components of individual domains, e.g., components of emotion; depression (e.g., apathy)
Use of existing longitudinal data sets to explore relationships of domains
Innovative approaches to evaluating multiple fluctuating variables over time (eg. simltaneous change models)
Methodologies for looking at underlying cause

3. Developing Phenotypes of Interactions
Measuring and defining areas of overlap of domains
Bi-directional interactions, multi-directional interactions
“Comorbidities” as shared environmental or genetic factors
When should this be considered a syndrome?
Longitudinal perspective
Analytical approaches to account for variations and interactions over time
Using clinical intervention studies focusing on one domain to explore effects on others
General tools
Mechanistic-based

4. Distinction between Symptoms, Syndromes and Diseases
Symptoms and/or risk factors
Syndrome: set of symptom/risk factor clusters with statistical properties
What are requisite statistical properties?
Disease: syndrome plus
Epidemiologic profile
Shared risk factors
Predictable natural history
Biological basis with biomarkers
Treatment response

5. Barriers to Development of Interventions
Phenotypes poorly defined
need better conceptual definitions of conditions (e.g., depression)
Need better operational definitions (instruments) to identify areas for clinical trials
Need concurrence between conceptual and operational definitions
Currently have only operational definitions (scores) in many instances
Diagnoses of inclusion vs diagnoses of exclusion (idiopathic conditions)
Current taxonomy often depends on specific biomarkers to define diseases/conditions

6. Research Priorities
Inventory of research on overlap of domains as basis for identifying future directions in
Meta-analyses
Prospective cohorts
Clinical trials
Encourage interdisciplinary scientists with targeted career development initiatives focusing on these area