Delirium, an acute disorder of attention and cognition, is a common, life-threatening, and potentially preventable clinical syndrome in older persons. Given its adverse impact on functioning and quality of life, delirium holds tremendous healthcare and societal implications for the individual, family, community, and healthcare systems. Despite its importance, fundamental advances in diagnosis, pathophysiology, and treatment have been lagging and there is a compelling need for more effective approaches to advance the field. Responding to RFA-AG-16-009, we propose the development of a collaborative research network, NIDUS (Network for Investigation of Delirium across the U.S.), to advance scientific discovery through a purposeful, coordinated effort.
Our specific aims are: (1) To create and maintain a database that will catalog elements and provide an efficient platform to enhance the sharing of data and biospecimens both within and outside the proposed network, facilitating multi-site collaboration, secondary analyses, and pilot studies to catalyze the field; (2) To develop a repository of core measures for delirium identification, diagnosis, and severity, and to harmonize data across all types of delirium studies; (3) To support pilot studies to encourage innovative research, targeted to priority areas (risk factors/prognosis; pathophysiology/biomarkers; diagnostic tools/phenomenology; and clinical interventions); (4) To mentor junior investigators interested in delirium research through training programs, educational resources, and integration into network activities; (5) To disseminate information on research resources, data sharing, training opportunities, and potential collaborations in a timely and effective manner to relevant stakeholders and to the broader scientific community. These synergistic aims will leverage the accumulated research expertise of over 28 delirium leaders (12 coinvestigators/Steering Committee and 16 Scientific Advisory Board members) across 27 institutions (who have committed in-kind support), to create the NIDUS collaborative network. NIDUS will provide a research infrastructure with 2 Resource Cores to provide: (1) a catalog of research resources/ databases and (2) a repository of core delirium measures. These will be augmented with 3 Task Forces providing: (1) pilot grants, (2) mentorship and career development support, and (3) dissemination of information through many approaches (e.g., scientific symposia, annual meetings, and social media). NIDUS will create a unique national resource that will facilitate and catalyze innovation in delirium research through providing core resources and training, targeting priority areas, promoting collaboration across disciplines and institutions, engaging and mentoring junior investigators across fields, and disseminating research findings broadly and effectively. Bringing together diverse multidisciplinary perspectives, including patient/family perspectives, holds great potential to shift research paradigms and enhance innovation. Through targeting delirium, the ultimate goal of the network is to improve healthcare and quality of life for all older persons.

Public Health Relevance

Delirium, an acute confusional state, is a common, serious, often unrecognized, and potentially preventable condition in the older population. Despite tremendous implications for patients, families, and society, it has been relatively neglected as an area of clinical research. The collaborative research network, NIDUS (Network for Investigation of Delirium across the U.S.), proposes to bring together researchers across disciplines and fields in coordinated efforts to address delirium. This application holds tremendous potential to advance our understanding of delirium, and ultimately, to improve healthcare and quality of life for older persons and their families.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Resource-Related Research Projects (R24)
Project #
5R24AG054259-04
Application #
9692477
Study Section
Special Emphasis Panel (ZAG1)
Program Officer
Roberts, Luci
Project Start
2016-09-30
Project End
2021-04-30
Budget Start
2019-05-01
Budget End
2020-04-30
Support Year
4
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Hebrew Rehabilitation Center for Aged
Department
Type
DUNS #
030832075
City
Boston
State
MA
Country
United States
Zip Code
02131
Mudge, Alison M; McRae, Prue; Hubbard, Ruth E et al. (2018) Hospital-Associated Complications of Older People: A Proposed Multicomponent Outcome for Acute Care. J Am Geriatr Soc :
Maybrier, Hannah R; Mickle, Angela M; Escallier, Krisztina E et al. (2018) Reliability and accuracy of delirium assessments among investigators at multiple international centres. BMJ Open 8:e023137
Rubin, Fred H; Bellon, Johanna; Bilderback, Andrew et al. (2018) Effect of the Hospital Elder Life Program on Risk of 30-Day Readmission. J Am Geriatr Soc 66:145-149
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
Inouye, Sharon K (2018) Delirium-A Framework to Improve Acute Care for Older Persons. J Am Geriatr Soc 66:446-451
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
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

Showing the most recent 10 out of 22 publications