I, Edward R. Marcantonio, MD, SM, am a board-certified geriatrician and patient-oriented aging researcher, Associate Professor of Medicine at Harvard Medical School (HMS) and Director of Research in the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center (BIDMC). The long term objectives of my career are to conduct patient-oriented research (POR) to improve the quality of care and outcomes of hospitalized older adults, and to provide mentoring to new investigators interested in POR in aging. Over the past 16 years, I have built a successful, independent, NIH-funded program of research focused on delirium (acute confusion), a common, morbid and costly condition in hospitalized older adults. I have conducted a series of observational and interventional studies designed to improve diagnosis, target individuals at risk, identify modifiable risk factors, and test intervention strategies to reduce the incidence, severity and duration of delirium. Through these studies, I have gained the knowledge and skills necessary to conduct high quality POR and to mentor new investigators, and have been recognized for my excellence in mentoring with two prestigious awards. In this context, the primary objectives of this K24 Award are: 1. To continue to build a research program around improving the quality and outcomes of care for hospitalized older adults with delirium. This objective will be accomplished through my currently funded studies, including an NIA-funded R01 entitled 3D-CAM: Deriving and validating a 3-Minute Diagnostic Assessment for Delirium, and my new research, a Biomarker Discovery for Delirium project described in this application. Receipt of the K24 will enable me to more effectively leverage these studies and other ongoing work to support the work of trainees, who will in turn expand my research program. 2. To build a mentorship program that will expand POR in aging at BIDMC and HMS, with a focus on delirium and related conditions. This objective will be accomplished through structured, individual mentorship of young investigators with a strong interest in POR. Protected time for mentorship will be provided by the K24 award. 3. To expand my mentorship program to include translational, interdisciplinary work around biomarker discovery for delirium, and biomarker applications to improve risk stratification, diagnosis, and prognostication of older adults with delirium. This objective will be accomplished through my new research project, career development activities, and interdisciplinary collaborations that will be facilitated by receipt of the K24 award. My objectives will be greatly facilitated by the superb academic environment and outstanding institutional support provided by HMS and the BIDMC Divisions of General Medicine and Gerontology.

Public Health Relevance

Delirium (acute confusion) complicates over 25% of the more than 12 million hospital stays per year of older adults in the U.S., leading to substantial morbidity, mortality, and cost. The goals of this K24 Award are to conduct patient-oriented research (POR) in the field of delirium, and to train new investigators in POR focused on improving diagnosis, monitoring, and treatment of delirium. The ultimate goal of this Award is to expand research activity and capacity in this critically important area, thereby improving the health of seniors.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Neuroscience of Aging Review Committee (NIA)
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Zieman, Susan
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Beth Israel Deaconess Medical Center
United States
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Kim, Dae Hyun; Kim, Caroline A; Placide, Sebastian et al. (2016) Preoperative Frailty Assessment and Outcomes at 6 Months or Later in Older Adults Undergoing Cardiac Surgical Procedures: A Systematic Review. Ann Intern Med 165:650-660
Herzig, Shoshana J; Marcantonio, Edward R (2016) Reply to ""Antipsychotics: Mortality Risk Themselves?"" J Am Geriatr Soc 64:2400
Kuczmarska, Aleksandra; Ngo, Long H; Guess, Jamey et al. (2016) Detection of Delirium in Hospitalized Older General Medicine Patients: A Comparison of the 3D-CAM and CAM-ICU. J Gen Intern Med 31:297-303
Cavallari, Michele; Dai, Weiying; Guttmann, Charles R G et al. (2016) Neural substrates of vulnerability to postsurgical delirium as revealed by presurgical diffusion MRI. Brain 139:1282-94
Vasunilashorn, Sarinnapha M; Marcantonio, Edward R; Gou, Yun et al. (2016) Quantifying the Severity of a Delirium Episode Throughout Hospitalization: the Combined Importance of Intensity and Duration. J Gen Intern Med 31:1164-71
Inouye, Sharon K; Marcantonio, Edward R; Kosar, Cyrus M et al. (2016) The short-term and long-term relationship between delirium and cognitive trajectory in older surgical patients. Alzheimers Dement 12:766-75
Cooper, Zara; Rogers Jr, Selwyn O; Ngo, Long et al. (2016) Comparison of Frailty Measures as Predictors of Outcomes After Orthopedic Surgery. J Am Geriatr Soc 64:2464-2471
Hshieh, Tammy T; Fox, Meaghan L; Kosar, Cyrus M et al. (2016) Head circumference as a useful surrogate for intracranial volume in older adults. Int Psychogeriatr 28:157-62
Jones, Richard N; Marcantonio, Edward R; Saczynski, Jane S et al. (2016) Preoperative Cognitive Performance Dominates Risk for Delirium Among Older Adults. J Geriatr Psychiatry Neurol :
Hshieh, Tammy T; Saczynski, Jane; Gou, Ray Yun et al. (2016) Trajectory of Functional Recovery After Postoperative Delirium in Elective Surgery. Ann Surg :

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