K07 Leadership Grant

描述(由申请人提供)：每年有超过250万美国老年人出现神志不清(急性混乱状态)，这是一种常见而严重的老年综合征，相关死亡率为25%-33%，并在接下来的一年中造成1000亿美元的医疗支出。然而，只有不到30%的病例得到确认，更少的病例得到了有效的预防干预。治疗和预防精神错乱的临床护理不足，这既是因为缺乏经验证据，也是因为现有证据没有以有效的方式始终如一地转化。候选人井上博士是一位老年病专家和经验丰富的临床调查员，他进行了开创性的工作，促进了我们对精神错乱的诊断、风险因素、预后和干预措施的理解。对于这一K07领导力奖，她建议开发美国第一个专门关注老年人精神错乱的项目，即“老年性妄想症卓越中心：研究、培训和教育增强(CEDARTREE)”，以促进精神错乱的研究和培训。她将在哈佛医学院-希伯来康复中心建立这个项目，汇集临床翻译研究、老年病学/老年学方面的世界知名资源，以及高超的跨学科专业知识和资源来支持该项目，这将促进整个大波士顿学术界的研究。其具体目标是：1)在精神错乱研究方面创建一个全面的跨学科培训和指导方案，包括正式的教学课程、研讨会系列、协作工作组和有经验的研究人员的个别化指导；2)开发核心资源，以吸引跨学科研究人员从事与精神错乱相关的协作研究(例如，网站研究开发补助金、获得新的研究技术和数据库、调查员名单服务、统计/方法专业知识和精神错乱书目)；以及3) 通过传播网站资源和教育内容，主办访问学者计划，年度科学研讨会，全国会议上的利益小组，以及发展国家联系以翻译证据，作为研究老龄化中的精神错乱的地方和国家资源。创新的方法将被纳入项目的各个层面：关于精神错乱的翻译研究(生物标记物、基因组学、高级神经成像)、解决方法学挑战的先进统计方法，以及创新的教育策略(例如，交互式在线教育方法)。对于井上博士来说，K07奖项将为关键领导领域的进一步职业发展提供机会，并保护开发、全面实施、评估、完善和建立自我维持的基础设施所需的时间，以确保该中心作为对老龄化研究和培训的持久贡献而继续存在。CEDARTREE是此类资源中的第一个，提供了一个创新的和急需的地方/国家资源和联络点，将加强对老年性精神错乱的研究能力，最终目标是改善老年人的健康和生活质量。

DESCRIPTION (provided by applicant): Over 2.5 million older Americans develop delirium (acute confusional state) each year, a common and serious geriatric syndrome, with associated mortality rates of 25-33% and accounting for >$100 billion in healthcare expenditures in the ensuing year. Yet, less than 30% of these cases are recognized, and even fewer receive proven preventive interventions. Clinical care to address and prevent delirium is deficient both because empirical evidence is lacking and because existing evidence is not consistently translated in an effective manner. The Candidate, Dr. Inouye, is an expert geriatrician and experienced clinical investigator, who has conducted ground-breaking work to advance our understanding of the diagnosis, risk factors, prognosis, and interventions for delirium. For this K07 Leadership Award, she proposes to develop the nation's first program focusing specifically on delirium in older adults, the "Center of Excellence for Delirium in Aging: Research, Training and Educational Enhancement (CEDARTREE)" to advance delirium research and training. She will establish this program at Harvard Medical School-Hebrew Rehabilitation Center, bringing together world-renowned resources in clinical-translational research, geriatrics/gerontology, and superb interdisciplinary expertise and resources to support the program, which will stimulate research across the greater Boston academic community. The specific aims are to: 1) To create a comprehensive interdisciplinary training and mentorship program in delirium research, including a formal didactic curriculum, seminar series, collaborative working groups, and individualized mentorship with experienced investigators; 2) To develop core resources to attract interdisciplinary investigators to engage in collaborative delirium-related research (e.g., website research development grants, access to novel research technologies and databases, investigator listserve, statistical/methodological expertise, and delirium bibliography); and 3) To serve as a local and national resource for research on delirium in aging through disseminating website resources and educational content, hosting a visiting scholar program, annual scientific symposium, interest groups at national meetings, and developing national linkages to translate evidence. Innovative approaches will be incorporated at every level of the program: translational research on delirium (biomarkers, genomics, advanced neuroimaging), advanced statistical methods to address methodological challenges, and innovative educational strategies (e.g., interactive on-line educational approaches). For Dr. Inouye, the K07 award will provide the opportunity for further career development in key leadership areas and protect time needed to develop, fully implement, evaluate, refine, and establish the self-sustaining infrastructure to assure continuation of the center as an enduring contribution to aging research and training. CEDARTREE represents the first resource of its kind, providing an innovative and much-needed local/national resource and focal point that will enhance the capacity for research on delirium in aging, with the ultimate goal of improving health and quality of life for seniors.