NIDUS II: Advanced-Stage Development and Utilization of the NIDUS Research Infrastructure to Advance Interdisciplinary Aging Research in Delirium
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Delirium, an acute disorder of attention and cognition, is a common, life-threatening, and costly condition for older adults with strong links to Alzheimer’s Disease and Related Dementias (ADRD). In 2015, responding to RFA-AG-16-009, we created the Network for Investigation of Delirium: Unifying Scientists (NIDUS I, R24AG054259), a collaborative interdisciplinary network of 28 investigators spanning 27 institutions which has provided research resources, meetings, pilot grants, and intensive mentorship for >90 trainees, leading to >340 first author papers and >46 grants as principal investigator. Despite this progress, a major knowledge gap in the field remains: safe and effective treatments for delirium. Thus, in response to PAR-20-071, we propose to expand the existing infrastructure as NIDUS II to advance the fundamental science needed to develop more effective treatments for delirium, and ultimately, improve outcomes for delirium in all older adults and in those with ADRD. Our specific aims are: (1) Harmonization Core. To develop and expand innovative measurement methods related to harmonization of delirium measures, outcomes, and predictors for clinical studies and treatment trials, and to refine measures of delirium diagnosis and severity in patients with all stages of ADRD. These approaches will allow us to combine data from multiple existing delirium studies; (2) Research Resources Core. To develop and expand the NIDUS Research Hub to create a collaborative infrastructure that will seed future interdisciplinary studies to advance delirium research (e.g., biomarker studies, intervention development studies); (3) Pilot/Exploratory Studies Core. To award pilot and exploratory grants that will promote collaborative interdisciplinary studies designed to utilize our infrastructure and advance research needed to develop better treatments for delirium. For this aim, we will assemble collaborative working groups (WG) which will address 4 scientific priority areas: (a) Measurement: Harmonize and refine measurement of delirium and related outcomes, including patients with ADRD, and to ensure accurate and sensitive measures for treatment trials; (b) Pathophysiology: Biomarker and mechanistic studies to advance our understanding and identify potential therapeutic targets for treatment trials; (c) Clinical Trials: Intervention development for new multicomponent treatment approaches; (d) Inter-Relationship of Delirium and ADRD: Epidemiologic, risk factor, pathophysiologic, prognostic, and especially treatment studies; (4) Career Development and Outreach Core: for early-stage investigators who will utilize the NIDUS II infrastructure and will be involved in working groups, pilot studies, and training events. Every aspect of NIDUS II is designed to seed innovative scientific discovery, and drive delirium research in a critically important direction: development of effective treatments for delirium, including delirium in ADRD. While we are building on the previous network, the innovation of the new NIDUS II network is the purposeful application and expansion of the infrastructure to advance scientific exploration and impact in specific priority areas of greatest benefit to older Americans. .
