Network for Investigation of Delirium Across the U.S. (NIDUS): Advancing the Field of Delirium with a New Interdisciplinary Research Network.

D a manifestation of brain organ dysfunction, presents acutely with impaired attention and disorganized thinking, and imposes a high degree of caregiver burden. Delirium can occur at any age, but occurs more often in older adults due to their increased vulnerability, affecting more than 2.6 million individuals in the United States each year (i.e., more than 5 individuals every minute) (U.S. Department of Health and Human Services, 2011). Typically following acute illness, hospitalization, or surgery, delirium often leads to loss of independence, cognitive decline, and increased morbidity and mortality. Moreover, delirium is associated with excess health care costs of >$164 billion per year (Inouye, Westendorp, & Saczynski, 2014; Leslie & Inouye, 2011). Delirium can be difficult to detect and manage and is receiving increased attention in the medical literature (Lee et al., 2017; Steis & Fick, 2008; Wilber & Ondrejka, 2016). Many factors, including cognitive impairment, infection, dehydration, and psychoactive medications, are predictive of delirium (Inouye et al., 2014). In most cases, delirium is multifactorial, which makes finding effective approaches for prevention and treatment highly challenging, and research studies methodologically complex. Importantly, delirium can be prevented with a multidimensional clinical strategy (Hshieh et al., 2015). Despite its importance, delirium is not well understood and vastly underrecognized. Fundamental advances in diagnosis and treatment of delirium are lagging. The pathophysiology of delirium remains poorly understood, and there are no biomarkers to serve as diagnostic indicators or therapeutic targets (Davis et al., 2017). Although the number of measures for screening and diagnosis of delirium has increased in the past decade, the proportion of patients with unrecognized delirium remains high (McCoy, Snapper, Stern, & Perlis, 2016; Morandi et al., 2017). In November 2016, a team of delirium experts led by Sharon K. Inouye, MD, MPH, Professor of Medicine at Harvard Medical School and Director of the Aging Brain Center at Hebrew SeniorLife’s Institute for Aging Research, was awarded a $3.7-million grant over 5 years. This award is the first of its kind from the National Institute on Aging/National Institutes of Health and is intended to build an interdisciplinary collaborative network of delirium researchers nationally and internationally. Dr. Inouye, along with 12 interdisciplinary experts in delirium research, will create the Network