My patient-oriented research (POR) program addresses knowledge gaps and barriers to care of hospitalized older adults with delirium. I seek renewal of my National Institute on Aging (NIA) K24 Award to continue to effectively leverage my ongoing research to mentor new investigators in aging research.
My Aims are:
Aim 1. To continue to conduct high quality POR research that will translate into improved care for hospitalized older adults with delirium, with an emerging focus on Implementation Science. This will be accomplished through my ongoing funded projects, and a newly funded R01 that moves toward implementation. Current Research: Much of my current research seeks a better understanding of delirium pathophysiology, with a goal of developing new biomarkers that could lead to improved diagnosis, monitoring, prognostication and the development of targeted therapies. My major project ?Biomarker Discovery for Delirium? within the P01 ?Interdisciplinary Study of Delirium and Its Long Term Outcomes? identified several new delirium biomarkers, including cytokines and acute phase reactants. With funding from the R01, ?Advancing Understanding of Postoperative Delirium Mechanisms via Multi-OMICS?, we are validating these protein biomarkers in larger samples, discovering new lipid and metabolite biomarkers, and examining cerebrospinal fluid. New Research: My new research seeks to implement efficient, straightforward tools for delirium identification in hospitalized elders. My recently completed R01, ?3D-CAM: Deriving and Validating a 3-minute Diagnostic Assessment for Delirium? developed and validated a high performing short diagnostic tool for delirium, the 3D- CAM, and identified ultra-brief screening tools. My newly funded R01: ?READI: Researching Efficient Approaches to Delirium Identification?, aims to test these tools in the hands of clinicians, and to assess barriers and facilitators to implementation. The long term of goal of this research is to implement routine assessment of delirium into care of hospitalized older adults, improving diagnosis, monitoring, and prognostication.
Aim 2 : To continue to use my research as a platform to mentor new POR investigators in delirium research, and to help them become independent investigators. This will support both the expansion of my research program and the field of delirium research.
This aim will be accomplished by: i. direct involvement of my trainees in my ongoing projects, ii. leveraging my programmatic research infrastructure to enable my mentees' investigations, and iii. ongoing recruitment of high caliber mentees to my research and mentoring program. Impact: Despite steady progress in delirium research over the past 25 years, much of the advances in this field have failed to reach the bedside of vulnerable hospitalized older adults. The focus of my ongoing projects and newly funded research, my proposed career development activities in Implementation Science, and my ongoing skilled mentorship of new investigators, will help to move the field of delirium research forward and will directly address the critical need to bring high quality care to the millions of older adults affected by delirium.

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. While there has been steady progress in delirium research, many advances have yet to impact the care of vulnerable hospitalized older adults. The ongoing and new research to be undertaken during the second cycle of this K24 Award, coupled with further expansion of Dr. Marcantonio's mentorship program to train outstanding young investigators, will address the critical need to bring high quality care to the bedside of the millions of older adults affected by delirium.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
2K24AG035075-06
Application #
9385479
Study Section
Neuroscience of Aging Review Committee (NIA)
Program Officer
Zieman, Susan
Project Start
2010-09-30
Project End
2022-04-30
Budget Start
2017-09-01
Budget End
2018-04-30
Support Year
6
Fiscal Year
2017
Total Cost
Indirect Cost
Name
Beth Israel Deaconess Medical Center
Department
Type
DUNS #
071723621
City
Boston
State
MA
Country
United States
Zip Code
02215
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
Gross, Alden L; Tommet, Doug; D'Aquila, Madeline et al. (2018) Harmonization of delirium severity instruments: a comparison of the DRS-R-98, MDAS, and CAM-S using item response theory. BMC Med Res Methodol 18:92
Miao, Huihui; Dong, Yuanlin; Zhang, Yiying et al. (2018) Anesthetic Isoflurane or Desflurane Plus Surgery Differently Affects Cognitive Function in Alzheimer's Disease Transgenic Mice. Mol Neurobiol 55:5623-5638
Hshieh, Tammy T; Fong, Tamara G; Schmitt, Eva M et al. (2018) The Better Assessment of Illness Study for Delirium Severity: Study Design, Procedures, and Cohort Description. Gerontology :1-10
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

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