# Defining the Phenotype of Complicated Delirium Associated with Long-Term Cognitive Decline

> **NIH NIH P01** · HEBREW REHABILITATION CENTER FOR AGED · 2021 · $148,979

## Abstract

ABSTRACT
Delirium has been considered a transient, reversible syndrome. However, long-term follow-up studies suggest
delirium is not always transient and reversible, and is correlated with increased risk of bad outcomes, such as
persistent and accelerated cognitive decline, Alzheimer's disease or dementia, death, and excess service utili-
zation. We have demonstrated that about half of people who develop postoperative delirium return to preoper-
ative baseline cognitive performance levels within about 8 weeks of surgery, but about a third of those who
develop postoperative delirium show accelerated cognitive decline out to 36 months following surgery. Our
working definition of complicated delirium, developed in our prior period of support, is delirium associated
with a higher degree (or pace) of cognitive decline in long-term follow-up (i.e., ≥ 2-3 years). In this sub-group,
the pace is similar to that observed among persons with mild cognitive impairment. Defining complicated
delirium in terms of long-term cognitive decline is problematic since the outcome cannot be detected for years.
Therefore, this Project will help identify predictors of complicated delirium to assist with early identification. Our
aims are: (1) to identify predictors for early identification of complicated delirium using an expert panel, (2)
identify predictors for early identification of complicated delirium using empiric data, and (3) to validate the
predictive models in an independent sample (external validity) and against clinical outcomes (predictive
validity). We will use information that is potentially available before, during and immediately following surgery.
We will also evaluate models using biomarkers derived from cerebrospinal fluid, serum, neurophysiologic
measures, and neuroimaging obtained before surgery. We will accomplish our aims with (a) the insights of
experts in delirium in a modified Delphi process; (b) secondary data analysis of the rich data already collected
in the SAGES I cohort, and (c) validation with new observational and clinical data collected within the context
of the new SAGES II cohort study. We will develop multiple models including preoperative, perioperative, and
postoperative predictor variable sets, and their combination. Our team includes experts in qualitative and
quantitative methodology and field leaders in the study of delirium. The ultimate goal of this work is to improve
delirium recognition and treatment by clinicians, and heighten the prognostic importance of delirium among
clinicians, their patients, and policy makers.

## Key facts

- **NIH application ID:** 10168402
- **Project number:** 5P01AG031720-09
- **Recipient organization:** HEBREW REHABILITATION CENTER FOR AGED
- **Principal Investigator:** Richard N Jones
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $148,979
- **Award type:** 5
- **Project period:** 2018-09-15 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10168402

## Citation

> US National Institutes of Health, RePORTER application 10168402, Defining the Phenotype of Complicated Delirium Associated with Long-Term Cognitive Decline (5P01AG031720-09). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10168402. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*