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Investigating Functional Outcomes and Cognition thrU Surgery (InFOCUS) study

Award Number: R01AG061161
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 03/01/2020
PERIOD OF PERFORMANCE END DATE: 02/28/2026

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Investigating Functional Outcomes and Cognition thrU Surgery (InFOCUS) study - Project Summary Cognitive decline with aging, including Alzheimer’s Disease and Related Dementias (ADRD), is a public health imperative that impacts quality of life and disability. Survivors of acute surgical or medical illness contribute greatly to the crisis of cognitive decline. Hospitalization confers a 1.5-2-fold increase in the odds of new onset dementia. Surgery is common in older adults, but it (and its resulting hospitalization) is associated with significant cognitive decline. Individual interventions to reduce this decline have exhibited limited success. The COgnitive and Physical Exercise to improve Outcomes after Surgery (COPE-iOS) study is evaluating a program of cognitive and physical training throughout the perioperative period. The intervention consists of adaptive computerized cognitive training plus guided aerobic exercise sessions, whereas the active attention control consists of a non-adaptive control computer game and guided stretching sessions. Comprising both prehabilitation and rehabilitation, the two study arms participate in activities for at least 2 weeks prior to surgery and for 3 months after discharge and involve significant weekly interaction with our study team. The study assesses global cognition, disability, depression, and mechanistic pathways. Multiple additional factors, including social support, may influence postoperative recovery, and organized support groups empower patients are associated with improved outcomes after surgery. Throughout the COPE-iOS study, participants in both arms consistently engage with a core team of personnel and sessions are group-based, allowing participants to engage with and support one another. This design provides a much higher level of interaction with providers and peers facing similar circumstances than standard perioperative care. While the active attention control design is essential to the COPE-iOS study to evaluate the efficacy of the cognitive and physical exercise program, the active attention control may confer more benefit to patients than previously anticipated. The Investigating Functional Outcomes and Cognition thrU Surgery (InFOCUS) study is a prospective observational cohort measuring cognitive and physical outcomes after major surgery in older adults who are receiving usual care. The primary hypothesis of this proposal is that outcomes in usual care will be worse than both a combined cognitive and physical exercise program and an active attention control program with regard to global cognition (Aim 1) and disabilities and depression (Aim 2). The InFOCUS study will enroll 125 patients ≥60 years old awaiting major inpatient surgery and assess global cognition, activities of daily living, and depression at baseline and at 3 and 12 months after discharge to allow better understanding of the efficacy of the combined cognitive and physical exercise program and further our knowledge on potential contributions of enhanced systemic support around major surgery to improve outcomes when compared to usual care.


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: 2025 ( Subtotal = $0 )
2025	2024	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	000	5	6/25/2025	NON-COMPETING CONTINUATION	$0
2025	2024	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	001	5	6/25/2025	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $1,248,159 )
2024	2024	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	000	5	2/16/2024	NON-COMPETING CONTINUATION	$729,596
2024	2024	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	001	5	6/4/2024	SUPPLEMENT FOR EXPANSION	$437,498
2024	2024	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	002	5	6/28/2024	NON-COMPETING CONTINUATION	$81,065
														Subtotal = $1,248,159

Issue Date FY: 2023 ( Subtotal = $813,435 )
2023	2023	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	000	4	1/31/2023	NON-COMPETING CONTINUATION	$813,435
														Subtotal = $813,435

Issue Date FY: 2022 ( Subtotal = $831,725 )
2022	2022	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	001	3	6/14/2022	NON-COMPETING CONTINUATION	$83,174
2022	2022	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	000	3	2/7/2022	NON-COMPETING CONTINUATION	$748,551
														Subtotal = $831,725

Issue Date FY: 2021 ( Subtotal = $838,525 )
2021	2021	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	000	2	2/17/2021	NON-COMPETING CONTINUATION	$838,525
														Subtotal = $838,525

Issue Date FY: 2020 ( Subtotal = $841,781 )
2020	2020	VANDERBILT UNIVERSITY MEDICAL CENTER	1161 21ST AVE S STE D3300 MCN	NASHVILLE	TN	37232	DAVIDSON	USA	Aging Research	000	1	2/27/2020	NEW	$841,781
														Subtotal = $841,781

Grand Total All Awards = $4,573,625

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Investigating Functional Outcomes and Cognition thrU Surgery (InFOCUS) study

Award Number: R01AG061161

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 03/01/2020

PERIOD OF PERFORMANCE END DATE: 02/28/2026

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