This proposal describes a career development plan that will transform Dr. Wang into a patient- oriented investigator focused on building novel interventions to prevent or delay Alzheimer's disease and other related dementias (ADRD) in delirium survivors. Dr. Wang's proposed project will involve the secondary data analysis of research subjects screened for the Pharmacologic Management of Delirium (PMD) study, a completed R01 clinical trial testing the efficacy of haloperidol to treat intensive care unit (ICU) delirium, merged with electronic medical record data from the Indiana Network for Patient Care Database. This project will examine the role of ICU delirium, pre-ICU cardiovascular risk factors, and post-ICU depression in the development of post-ICU cognitive impairment and ADRD. The completion of this project will establish Dr. Wang's career as a patient oriented investigator to identify risk factors for post-ICU cognitive impairment and ADRD and develop targeted interventions in ICU delirium survivors. This proposed career development plan integrates 1) coursework and structured didactics in biostatistics, epidemiology, and clinical trials methodology that lead up to a master's degree in clinical research, 2) leadership skills and interdisciplinary collaboration to prepare her for a career as a patient-oriented investigator, 3) participation in national meetings to develop expertise in older delirium survivors and ADRD, 4) a multidisciplinary mentorship panel with a strong track record of growing junior investigators, and 5) an ideal research environment to study the intersection of the fields of delirium and ADRD. This environment includes an internationally recognized NIH-funded PMD Study Group, the distinguished Indiana University Center for Aging Research, the NIA-funded Indiana Alzheimer's Disease Center, and the NIH- funded Indiana Clinical and Translational Sciences Institute (CTSI). This career development award will guarantee protected time that will be necessary to advance the candidate's career in older ICU delirium survivors and ADRD. In addition, the award will provide critical support to collect data for future R01 clinical trial to test an intervention to prevent and delay post-ICU cognitive impairment and ADRD in delirium survivors.
Patients with delirium are at higher risk to develop subsequent mild cognitive impairment or Alzheimer's disease and other related dementias (ADRD). Patients hospitalized in the intensive care unit (ICU) may represent a model cohort to more deeply understand the connection between delirium and ADRD because they are at high risk for developing both disorders. This project will examine the role of ICU delirium, cardiovascular risk factors, and post-ICU depression in the development of subsequent cognitive impairment and ADRD in ICU delirium survivors.