Pilot / Exploratory Studies Core (PESC): Project Summary The overall goal of the Pilot / Exploratory Studies Core (PESC) is to cultivate and support cutting edge pilot and exploratory studies that will advance the development of effective prevention and/or therapies for frailty and hence facilitate independence in older adults. The PESC Core leaders, in close collaboration with other core leaders and congruent with the scientific vision of the OAIC, sets scientific goals for the next stages of pilot frailty research. They then work to identify investigators whose expertise and career goals would be applicable to furthering etiological and interventional knowledge in the targeted areas. Pilot and exploratory studies that can collect data required in order to select or design the future large-scale or confirmatory studies needed to establish frailty mechanisms, improve measurement and diagnosis, determine etiologies, or develop novel treatment approaches are prioritized. Studies selected for funding in the first year of this cycle include a study that uses video-based pose estimation to develop an automated, quantitative frailty and pre-frailty assessment in older adults, a multimodal approach to finding genetic signatures of frailty in TOPMed population studies, and a pilot study of provision of digital access to older, frail and underserved patients awaiting kidney transplant to facilitate improved health care in this most vulnerable group. The specific aims of the PESC are to 1) solicit, select, and support pilot studies that advance the science and translation of frailty research, 2) to support the development of well-designed and informative pilot studies, 3) to provide and conduct longitudinal mentorship to supported investigators as well as provide oversight through completion of the pilot award and pursuit of funding for the next stage of research, 4) to further guide the translation of any pilot study results, and 5) to expand the research environment and network of frailty-focused investigators needed to accomplish the overall OAIC goals. These aims will be carried out in close collaboration with biostatistics, biological mechanisms, and clinical translational and recruitment core leaders to ensure optimal design and access to core resources needed for study success. A new Technology Assessment and Solutions Core (RC4) will bring new and unique engineering focused studies into this core. This core will also guide the translation of pilot work into a deeper understanding of the basic biology and population implications of frailty and into interventions that will prevent or treat frailty hence help maintain independence.