Field Core (Core B)

核心B摘要 题为“谵妄、痴呆和脆弱的大脑： “方法”试图通过一个定义谵妄，痴呆和大脑脆弱性的复杂关系， 一系列五个相互关联的项目，每个项目审查脆弱性的一个独特方面。场核心将 支持所有项目，并有以下具体目标： 目的1：对原始的择期手术后成功老化（SAGES I）队列进行评估 基线时痴呆的发生率（N=560），确保尽可能高的参与者保留率和研究完整性 变量活动包括：1）对于整个SAGES I队列，完成两波长期随访 访谈：第一波（1-3年）将确保至少5年的随访，第二波（1-3年）将确保至少5年的随访。 （3-5年）将确保至少8年的随访; 2）邀请128名SAGES I参与者， 根据他们的指数入院谵妄状态和与年龄和基线认知能力相匹配的频率进行采样 状态，返回医院进行详细评估，包括通过 腰椎穿刺（LP）用于阿尔茨海默病（AD）和炎症生物标志物测量， 血浆AD和炎症标志物测量、磁共振成像（MRI）研究，以及 经颅磁刺激（TMS）-脑电图（EEG）研究。 目的2：建立一个新的队列，称为SAGES II，包括400例接受全髋关节或膝关节置换术的患者 在两个学术医疗中心，贝丝以色列女执事医疗中心（BIDMC）和 布里格姆妇女医院（BWH），并随访该队列18个月，随访时间延长至36个月 个月与SAGES II队列相关的活动包括：1）识别、接近和招募合格的 目标是实现尽可能高的参与率的患者; 2）在 手术，在整个索引住院期间每天进行谵妄的院内评估，以及随访 在术后1、2、6、12、18个月进行评估，并在24和36个月进行延长随访; 3） 通过收集AD的CSF和血液样本，为每个组成项目提供专业支持 和炎症生物标志物测量，以及转诊患者进行MRI、TMS和EEG研究。 目标3：雇用、培训和监督所有外地工作人员的活动，确保协调 SAGES I和II队列研究，包括研究受试者安全性和高质量数据收集。 通过执行这些目标，现场核心将在计划的各个方面发挥重要作用 该项目将定义谵妄、痴呆和大脑脆弱性之间的复杂关系。励磁铁芯 在第一个供资周期内，基金在实现其所有目标方面取得了巨大成功。在更新中，我们将 执行相同的原则和程序，雇用许多相同的领导人和现场团队工作人员 成员这种连续性确保了持续成功的极高可能性。

CORE B ABSTRACT The Program Project (P01) entitled “Delirium, Dementia and the Vulnerable Brain: An Integrative Approach” seeks to define the complex relationship of delirium, dementia, and brain vulnerability through a series of five, interrelated projects, each of which examines a unique aspect of vulnerability. The Field Core will support all of the projects and has the following Specific Aims: Aim 1: To perform assessments on the original Successful Aging after Elective Surgery (SAGES I) cohort free of dementia at baseline (N=560), ensuring the highest possible participant retention and completeness of study variables. Activities include: 1) For the entire SAGES I cohort, completing two waves of long-term follow-up interviews: the first wave (years 1-3) will ensure a minimum of 5 years of follow-up, and the second wave (years 3-5) will ensure a minimum of 8 years of follow-up; 2) Inviting 128 SAGES I participants, probability sampled based on their index admission delirium status and frequency matched by age and baseline cognitive status, to return to the hospital for a detailed evaluation, including cerebrospinal fluid (CSF) collection via lumbar puncture (LP) for Alzheimer's Disease (AD) and inflammatory biomarker measurement, phlebotomy for plasma AD and inflammatory marker measurement, magnetic resonance imaging (MRI) studies, and transcranial magnetic stimulation (TMS)-electroencephalography (EEG) studies. Aim 2: To accrue a new cohort, called SAGES II, of 400 patients undergoing total hip or knee replacements under spinal anesthesia at two academic medical centers, Beth Israel Deaconess Medical Center (BIDMC) and Brigham and Women's Hospital (BWH), and to follow this cohort for 18 months with extended follow-up to 36 months. Activities related to the SAGES II cohort include: 1) identifying, approaching, and enrolling eligible patients with a goal of achieving the highest possible participation; 2) performing baseline assessments prior to surgery, in-hospital assessments for delirium daily throughout the index hospitalization, and follow-up assessments at 1, 2, 6, 12, 18, months after surgery, with extended follow-up at 24 and 36 months; 3) providing specialized support for each of the component projects by collecting CSF and blood samples for AD and inflammatory biomarker measurement, and referring patients for MRI, TMS, and EEG studies. Aim 3: To hire, train, and monitor the activities of all field staff, ensuring coordination of all aspects of the SAGES I and II cohort studies including study participant safety, and high quality data collection. Through execution of these Aims, the Field Core will play an essential role in all aspects of the Program Project, which will define the complex relationship of delirium, dementia, and brain vulnerability. The Field Core has been highly successful in achieving all of its Aims in the first funding cycle. In the renewal, we will implement the same principles and procedures, employ many of the same leaders and field team staff members. This continuity ensures a very high likelihood of continued success.