Engaging Hospitalized Patients and Family Caregivers to Identify and Prevent Delirium Superimposed on Dementia: An Intervention Mapping Approach.

PROJECT SUMMARY/ABSTRACT This career development proposal will provide Blair Golden, MD MS, a physician-scientist at The University of Wisconsin-Madison School of Medicine and Public Health, with the training required for success as an independent investigator researching interventions to improve the delivery of patient- and family-centered care

for hospitalized adults with Alzheimer's Disease and Alzheimer's Disease Related Dementias (AD/ADRD). Nearly half of all hospitalized patients with AD/ADRD develop delirium superimposed on dementia (DSD), which is associated with significant morbidity and mortality. DSD also leads to adverse impacts for family

caregivers, compounding pre-existing caregiver stresses and negative impacts on wellbeing. Despite its substantial burden, DSD remains under-detected and poorly managed in hospitalized patients due in part to under-developed approaches for assessing pre-existing impairment and other individual characteristics that

are critical to delivering tailored prevention strategies. Evidence-based programs for delirium have emphasized the role of family engagement in recognition and management, but approaches to proactively engaging family members and patients with AD/ADRD in DSD detection and prevention remain underdeveloped. The

overarching goal of this K23 proposal is to establish patient and family caregiver-centered communication and engagement practices capable of proactively addressing information needs and soliciting participation in DSD identification and prevention that are feasible and scalable. Understanding family and patient communication

and information needs regarding DSD could not only improve the delivery of patient and family-centered care, but also potentially reduce family and patient suffering and improve DSD identification and prevention. As a junior faculty member at an institution with extensive infrastructure to support early-stage investigators, Dr.

Golden is in an optimal environment to complete the proposed research project and pursue advanced training. Her career development plan includes formal coursework, intensive mentorship, and experiential training in 1) mixed methods, survey, and intervention mapping approaches 2) delirium assessment and prevention 3)

research engagement and clinical care of patients with AD/ADRD and 4) pragmatic clinical trial design. To ensure success, she has identified expert mentors in these disciplines with outstanding track records in training independent investigators and secured protected time for this work. This award addresses a significant clinical

dilemma and serious gap in AD/ADRD and delirium research while affording the education and mentored research experience critical to prepare Dr. Golden to lead an independent research program.