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.
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