Mid-Career Mentoring Award for Patient-Oriented Research in Aging

描述(申请人提供)：我，Edward R.Marcantonio，医学博士，SM，是一名董事会认证的老年病学家和以患者为导向的老年研究员，哈佛医学院(HMS)医学副教授，贝丝以色列女执事医学中心(BIDMC)普通医学和初级保健部门的研究主任。我职业生涯的长期目标是进行以患者为中心的研究(POR)，以改善住院老年人的护理质量和结果，并为对POR感兴趣的新研究人员提供衰老方面的指导。在过去的16年里，我建立了一个成功的、独立的、由NIH资助的研究项目，专注于精神错乱(急性精神错乱)，这是一种住院老年人的常见、病态和昂贵的疾病。我进行了一系列观察性和干预性研究，旨在改善诊断，针对处于危险中的个人，确定可改变的危险因素，并测试干预策略，以减少神志不清的发生率、严重程度和持续时间。通过这些学习，我获得了进行高质量POR和指导新调查人员所需的知识和技能，并因我在指导方面的出色表现而获得两个享有盛誉的奖项。在这种背景下，这个K24奖的主要目标是：1.继续建立一个围绕改善住院老年精神错乱患者的护理质量和结果的研究计划。这一目标将通过我目前资助的研究来实现，包括NIA资助的题为3D-CAM的R01：推导和验证Delirium的3分钟诊断评估，以及我的新研究，本申请中描述的Biomarker Discovery for Delirium项目。收到K24将使我能够更有效地利用这些研究和其他正在进行的工作来支持学员的工作，他们将反过来扩大我的研究计划。2.建立一个导师计划，将扩大北京儿童医院和HMS的POR老龄问题，重点是精神错乱和相关疾病。这一目标将通过对POR有浓厚兴趣的年轻调查人员进行有组织的、个人的指导来实现。K24奖将提供受保护的指导时间。3.扩大我的导师计划，包括围绕发现精神错乱的生物标记物的翻译、跨学科工作，以及生物标记物的应用，以改善老年人精神错乱的风险分层、诊断和预测。这一目标将通过我的新研究项目、职业发展活动和跨学科合作来实现，这些都将通过获得K24奖来促进。HMS和BIDMC普通医学和老年学分部提供的一流的学术环境和出色的机构支持将极大地促进我的目标。 与公共卫生相关：精神错乱(急性精神错乱)使美国每年1200多万老年人住院中的25%以上复杂化，导致相当大的发病率、死亡率和成本。该K24奖的目标是在精神错乱领域进行以患者为中心的研究(POR)，并培训新的POR研究人员，专注于改善精神错乱的诊断、监测和治疗。该奖项的最终目标是扩大在这一至关重要的领域的研究活动和能力，从而改善老年人的健康。

DESCRIPTION (provided by applicant): 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.