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

谵妄，一种急性注意力和认知障碍，是一种常见的，危及生命的，昂贵的条件， 与阿尔茨海默病和相关痴呆症（ADRD）有密切联系的老年人。2015年，响应 RFA-AG-16-009，我们创建了谵妄调查网络：统一科学家（NIDUS I， R24 AG 054259），这是一个跨学科协作网络，由27个机构的28名研究人员组成， 为90多名学员提供了研究资源、会议、试点赠款和强化指导， 第一作者论文和>46赠款作为主要研究者。尽管取得了这一进展， 该领域仍然是：安全有效地治疗谵妄。因此，针对PAR-20-071，我们建议 扩大现有的基础设施，如NIDUS II，以推进发展更多 有效治疗谵妄，并最终改善所有老年人和那些 关于ADRD我们的具体目标是：（1）协调核心。开发和扩展创新测量 与临床研究中谵妄测量、结局和预测因素的协调相关的方法， 治疗试验，并完善措施谵妄诊断和严重程度的患者与所有阶段的ADRD。 这些方法将使我们能够联合收割机从多个现有的谵妄研究数据;（2）研究 核心资源开发和扩大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提供种子，以推进谵妄研究（例如，生物标志物研究，干预 开发研究）;（3）试点/探索性研究核心。授予试点和探索性赠款， 促进旨在利用我们的基础设施和推进研究的跨学科合作研究 需要开发更好的治疗谵妄的方法。为此，我们将组建协作工作组， (WG)（a）计量：统一和完善对 谵妄和相关结局，包括ADRD患者，并确保准确和敏感的措施 （B）病理生理学：生物标志物和机制研究，以促进我们的理解， 为治疗试验确定潜在的治疗靶点;（c）临床试验： 多组分治疗方法;（d）谵妄和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基础设施并将参与工作组的早期研究人员， 试点研究和培训活动。NIDUS II的每一个方面都旨在为创新的科学发现提供种子， 并将谵妄研究推向一个至关重要的方向：发展有效的谵妄治疗方法， 包括ADRD中的谵妄虽然我们是建立在以前的网络，创新的新NIDUS II 网络是基础设施的有目的的应用和扩展，以推进科学探索， 对美国老年人最有利的具体优先领域的影响。 .

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. .