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.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24AG035075-04
Application #
8532791
Study Section
National Institute on Aging Initial Review Group (NIA)
Program Officer
Zieman, Susan
Project Start
2010-09-30
Project End
2015-05-31
Budget Start
2013-09-01
Budget End
2014-05-31
Support Year
4
Fiscal Year
2013
Total Cost
$190,955
Indirect Cost
$14,145
Name
Beth Israel Deaconess Medical Center
Department
Type
DUNS #
071723621
City
Boston
State
MA
Country
United States
Zip Code
02215
Vasunilashorn, Sarinnapha M; Ngo, Long H; Chan, Noel Y et al. (2018) Development of a Dynamic Multi-Protein Signature of Postoperative Delirium. J Gerontol A Biol Sci Med Sci :
Naidus, Elliot L; Lasalvia, Mary T; Marcantonio, Edward R et al. (2018) The Diagnostic Yield of Noninvasive Microbiologic Sputum Sampling in a Cohort of Patients with Clinically Diagnosed Hospital-Acquired Pneumonia. J Hosp Med 13:34-37
O'Gara, Brian; Marcantonio, Edward R; Pascual-Leone, Alvaro et al. (2018) Prevention of Early Postoperative Decline (PEaPoD): protocol for a randomized, controlled feasibility trial. Trials 19:676
Racine, Annie M; Gou, Yun; Fong, Tamara G et al. (2018) Correction for retest effects across repeated measures of cognitive functioning: a longitudinal cohort study of postoperative delirium. BMC Med Res Methodol 18:69
Racine, Annie M; Fong, Tamara G; Gou, Yun et al. (2018) Clinical outcomes in older surgical patients with mild cognitive impairment. Alzheimers Dement 14:590-600
Fick, Donna M; Inouye, Sharon K; McDermott, Caroline et al. (2018) Pilot Study of a Two-Step Delirium Detection Protocol Administered By Certified Nursing Assistants, Physicians, and Registered Nurses. J Gerontol Nurs 44:18-24
Racine, Annie M; D'Aquila, Madeline; Schmitt, Eva M et al. (2018) Delirium Burden in Patients and Family Caregivers: Development and Testing of New Instruments. Gerontologist :
Vasunilashorn, Sarinnapha M; Fong, Tamara G; Albuquerque, Asha et al. (2018) Delirium Severity Post-Surgery and its Relationship with Long-Term Cognitive Decline in a Cohort of Patients without Dementia. J Alzheimers Dis 61:347-358
Graham, Kelly L; Auerbach, Andrew D; Schnipper, Jeffrey L et al. (2018) Preventability of Early Versus Late Hospital Readmissions in a National Cohort of General Medicine Patients. Ann Intern Med 168:766-774
Kim, Dae Hyun; Mahesri, Mufaddal; Bateman, Brian T et al. (2018) Longitudinal Trends and Variation in Antipsychotic Use in Older Adults After Cardiac Surgery. J Am Geriatr Soc 66:1491-1498

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