NIDUS II: Advanced-Stage Development and Utilization of the NIDUS Research Infrastructure to Advance Interdisciplinary Aging Research in Delirium

NIDUS II：NIDUS 研究基础设施的高级开发和利用，以推进谵妄的跨学科衰老研究

• 批准号: 10561669
• 负责人: SHARON K. INOUYE
• 金额: $ 80万
• 依托单位: HEBREW REHABILITATION CENTER FOR AGED
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10561669
• 关键词: Acute Disease; Address; Aging; Alzheimer' s disease patient; Alzheimer' s disease related dementia; American; Area; Assessment tool; Attention; Award; Biological Markers; Clinical; Clinical Research; Clinical Treatment; Clinical Trials; Cognition; Data; Data Analyses; Data Set; Databases; Delirium; Development; Diagnosis; Discipline; Elderly; Ensure; Epidemiology; Event; Functional disorder; Future; Goals; Grant; Healthcare Systems; Human; Impaired cognition; Incidence; Individual; Infrastructure; Institution; Intensive Care; Interdisciplinary Study; Investigation; Knowledge; Life; Link; Long-Term Care; Measurement; Measures; Mental Depression; Mentorship; Meta-Analysis; Metadata; Methods; National Institute on Aging; Outcome; Palliative Care; Paper; Participant; Pathway interactions; Patients; Pilot Projects; Prevention program; Principal Investigator; Public Health; Quality of Care; R24; Research; Research Design; Research Infrastructure; Research Personnel; Resources; Risk Factors; Science; Scientific Advances and Accomplishments; Scientist; Severities; Training; acute care; biomarker validation; career development; clinical epidemiology; cost; data resource; design; effective therapy; epidemiology study; frailty; functional decline; improved outcome; innovation; interdisciplinary collaboration; interest; meetings; multiple chronic conditions; novel; outreach; predict clinical outcome; prognostic; response; secondary analysis; support network; targeted therapy trials; therapeutic target; therapy development; treatment strategy; treatment trial; webinar; working group

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. .

谵妄是一种严重的注意力和认知障碍，是一种常见的、危及生命且代价高昂的疾病。 与阿尔茨海默病和相关痴呆症 (ADRD) 密切相关的老年人。 2015年，响应 RFA-AG-16-009，我们创建了谵妄调查网络：团结科学家（NIDUS I， R24AG054259），一个跨学科协作网络，由 27 个机构的 28 名研究人员组成， 为超过 90 名受训者提供研究资源、会议、试点资助和强化指导，导致超过 340 名受训者 第一作者论文和作为首席研究员获得超过 46 项资助。尽管取得了这些进展，但在以下方面仍存在重大知识差距： 该领域仍然是：治疗谵妄的安全有效的方法。因此，针对 PAR-20-071，我们建议 扩展现有的基础设施，如 NIDUS II，以推进开发更多产品所需的基础科学 有效治疗谵妄，并最终改善所有老年人和老年人的谵妄结局 与ADRD。我们的具体目标是： (1) 协调核心。开发和扩展创新测量 与协调谵妄测量、结果和临床研究预测因素相关的方法 治疗试验，并完善 ADRD 各阶段患者谵妄诊断和严重程度的测量方法。 这些方法将使我们能够结合多项现有谵妄研究的数据； （二）研究 资源核心。开发和扩展 NIDUS 研究中心以创建协作基础设施 这将为未来的跨学科研究奠定基础，以推进谵妄研究（例如生物标志物研究、干预 发展研究）； (3) 试点/探索性研究核心。授予试点和探索性拨款， 促进跨学科合作研究，旨在利用我们的基础设施和推进研究 需要开发更好的谵妄治疗方法。为此，我们将组建协作工作组 （工作组）将涉及 4 个科学优先领域： (a) 测量：协调和完善测量 谵妄和相关结果，包括 ADRD 患者，并确保措施准确和灵敏 用于治疗试验； (b) 病理生理学：生物标志物和机制研究，以增进我们的理解和 确定治疗试验的潜在治疗靶点； (c) 临床试验：针对新药物的干预开发 多成分治疗方法； (d) 谵妄与 ADRD 的相互关系：流行病学、危险因素、 病理生理学、预后，尤其是治疗研究； (4) 职业发展和外展核心： 对于将利用 NIDUS II 基础设施并参与工作组的早期研究人员， 试点研究和培训活动。 NIDUS II 的各个方面都旨在培育创新的科学发现， 并将谵妄研究推向一个至关重要的方向：开发谵妄的有效治疗方法， 包括 ADRD 中的谵妄。虽然我们在之前的网络基础上进行建设，但新的 NIDUS II 的创新 网络是基础设施的有目的地应用和扩展，以推进科学探索和 对美国老年人最有利的特定优先领域的影响。 。