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BRAIN-ICU-2 Study: Bringing to Light the Risk Factors And Incidence of Neuropsychological Dysfunction (Dementia) in ICU Survivors, 2nd Study

Award Number: R01AG058639
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Project Summary Of people admitted emergently to the Intensive Care Unit (ICU) in respiratory failure or shock, 50% to 70% develop delirium (by far the highest in any healthcare setting). The duration of this delirium independently predicts earlier death, longer hospital stay, and higher healthcare expenses annually. Delirium in ICU patients has been shown to be the strongest potentially modifiable risk factor for development of a long-term cognitive impairment, which resembles moderate to severe Alzheimer’s Disease and Related Dementias (ADRDs). Thus, medical and surgical ICU patients on ventilators or in shock are a prime population in whom to study the relationship between delirium and dementia. Our NIA-funded, NEJM published, and PAR-18-029 cited BRAIN- ICU-1 study [Bringing to light the Risk factors And Incidence of Neuropsychological dysfunction in ICU Survivors, 1st Study] showed over that one-third of ICU survivors (without preexisting dementia) emerged with new cognitive impairments or ADRD at 1 year. Some BRAIN-ICU-1 patients had cognitive resilience against ADRD, but others developed a persistent or progressive dementia-like illness. We are eager to develop interventions against this ICU-related dementia, but without knowing more about this form of brain injury, we are very limited. Now, we have pilot neuroimaging (MRI) data show that acute ICU delirium is associated with atrophy of the whole brain, frontal lobe, and hippocampus, but this problem requires an in-depth investigation. We know abnormal brain proteins (amyloid, tau) relate to Alzheimer’s disease, however, we know nearly nothing about protein pathology or other causes of this ICU-related dementia. It is critical to understand why ICU survivors are losing their jobs, and the leadership as matriarchs and patriarchs of their families. This BRAIN-ICU-2 study [Bringing to light the Risk factors And Incidence of Neuropsychological dysfunction (dementia) in ICU Survivors, 2nd Study] is in direct response to PAR-18-029 and will determine ICU patients’ main paths to decline, maintenance, or recovery of brain function. We will answer gaps in knowledge about long-term outcome of post-ICU brain disease by following the remaining ICU survivors from the original BRAIN-ICU-1 study with complete cognitive testing for the first time ever to 14 years (AIM 1). We will consent and enroll 567 new ICU patients at Vanderbilt and Rush Universities (i.e., new ICU cohort) and determine how detailed neuroimaging and cerebrospinal fluid samples can help reveal locations and mechanisms of injury beyond what we learned from the clinical information collected in our original study (AIM 2). Importantly, we are partnering with the world-renowned Rush Alzheimer's Disease Research Center brain bank program so that all patients enrolled in Aims 1 and 2 will able to donate their brains to science for the first-ever in-depth pathological study of those who do and do not get post-ICU dementia to define this disease formally (AIM 3).


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $2,839,648 )
2024	2024	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	000	5	1/25/2024	NON-COMPETING CONTINUATION	$2,839,648
														Subtotal = $2,839,648

Issue Date FY: 2023 ( Subtotal = $3,532,548 )
2023	2023	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	000	4	1/25/2023	NON-COMPETING CONTINUATION	$3,532,548
														Subtotal = $3,532,548

Issue Date FY: 2022 ( Subtotal = $0 )
2022	2021	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	000	3	2/3/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2021 ( Subtotal = $3,630,964 )
2021	2021	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	000	3	2/18/2021	NON-COMPETING CONTINUATION	$3,630,964
														Subtotal = $3,630,964

Issue Date FY: 2020 ( Subtotal = $4,763,561 )
2020	2020	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	002	2	8/31/2020	SUPPLEMENT FOR EXPANSION	$868,245
2020	2020	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	000	2	1/31/2020	NON-COMPETING CONTINUATION	$3,470,697
2020	2020	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	003	2	9/2/2020	SUPPLEMENT FOR EXPANSION	$0
2020	2020	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	001	2	4/28/2020	SUPPLEMENT FOR EXPANSION	$424,619
														Subtotal = $4,763,561

Issue Date FY: 2019 ( Subtotal = $3,262,056 )
2019	2019	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	000	1	4/14/2019	NEW	$3,262,056
2019	2019	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	001	1	4/17/2019	NEW	$0
														Subtotal = $3,262,056

Grand Total All Awards = $18,028,777

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BRAIN-ICU-2 Study: Bringing to Light the Risk Factors And Incidence of Neuropsychological Dysfunction (Dementia) in ICU Survivors, 2nd Study

Award Number: R01AG058639

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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