The applicant, Michael LaMantia, MD, MPH is a geriatric physician and Assistant Professor of Medicine in the Division of General Internal Medicine and Geriatrics in the Department of Medicine at Indiana University. He additionally is a scientist at the Indiana University Center for Aging Research and Regenstrief Institute, Inc. The candidate's long-term career goal is to become a geriatrics clinical investigator who designs and implements systems of care to promote and improve the well-being of vulnerable older adults in the emergency department (ED) and other acute care environments. The research proposed in this application will provide information regarding the evaluation of delirium among older adults in the ED that is needed to improve the management of this serious condition. The candidate's immediate objectives are: (1) to acquire the research skills necessary to succeed in this program of research;(2) to gain the background needed to lead the design and implementation of systems that will provide better care to older adults in the acute care environment;(3) to conduct a mentored research program to evaluate the patient, provider, and workflow factors that influence the detection of delirium by emergency physicians (EPs);(4) to determine, by querying EPs the most effective cognitive strategies employed to recognize delirium;and (5) to extend the body of research regarding both short and long-term outcomes of patients whose delirium is either recognized or unrecognized in the ED . At the conclusion of this project, the candidate will apply data obtained from these studies to propose a logical and well-designed intervention to improve recognition and management of older adults with delirium in the ED in his first R01 submission. The career development plan proposes course work, a research project, and mentoring from a team of experienced investigators with expertise in a variety of relevant fields (health services research, medical sociology, emergency medicine, and delirium science) to provide synergistic advice on the accomplishment of the proposed projects. The applicant will benefit from a host of local resources available to support him in the completion of this project including the Indiana University School of Medicine and IU Center for Aging Research;the Regenstrief Institute and its extensive Regenstrief Medical Record System;as well as the clinical resources of the Indiana University Department of Emergency Medicine.
Delirium is a serious condition that affects approximately 10% of older adults who seek care in the emergency department, yet is believed to go unrecognized in the majority of cases. If we are to improve the care and management of older adults with delirium, it is critical that we understand the dynamics that affect delirium recognitin by emergency providers. The goal of this research is to determine the factors that influence delirium recognition and to discern those approaches to delirium assessment that are most associated with its identification.
|LaMantia, Michael A; Platts-Mills, Timothy F (2017) Bending the Curve of Health Trajectories for Older Adults Discharged From the Emergency Department. Ann Emerg Med 69:434-436|
|LaMantia, Michael A; Messina, Frank C; Jhanji, Shola et al. (2017) Emergency medical service, nursing, and physician providers' perspectives on delirium identification and management. Dementia (London) 16:329-343|
|LaMantia, Michael A; Lane, Kathleen A; Tu, Wanzhu et al. (2016) Patterns of Emergency Department Use Among Long-Stay Nursing Home Residents With Differing Levels of Dementia Severity. J Am Med Dir Assoc 17:541-6|
|LaMantia, Michael A; Perkins, Anthony J; Gao, Sujuan et al. (2016) Response to depression treatment in the Aging Brain Care Medical Home model. Clin Interv Aging 11:1551-1558|
|Bernard, Brittany L; Bracey, Lauren E; Lane, Kathleen A et al. (2016) Correlation Between Caregiver Reports of Physical Function and Performance-based Measures in a Cohort of Older Adults With Alzheimer Disease. Alzheimer Dis Assoc Disord 30:169-74|
|Cagle, John G; LaMantia, Michael A; Williams, Sharon W et al. (2016) Predictors of Preference for Hospice Care Among Diverse Older Adults. Am J Hosp Palliat Care 33:574-84|
|LaMantia, Michael A; Stump, Timothy E; Messina, Frank C et al. (2016) Emergency Department Use Among Older Adults With Dementia. Alzheimer Dis Assoc Disord 30:35-40|
|Vollmar, H C; Thyrian, J R; LaMantia, M A et al. (2016) [Aging Brain Care Program from Indianapolis: Transferability to the German healthcare system]. Z Gerontol Geriatr 49:32-6|
|Austrom, Mary Guerriero; Carvell, Carly A; Alder, Catherine A et al. (2016) Workforce development to provide person-centered care. Aging Ment Health 20:781-92|