Delirium and Population Health Informatics Cohort (DELPHIC) Study
Research type
Research Study
Full title
Delirium and Population Health Informatics Cohort (DELPHIC) Study\n(known locally as the Long-term Information and Knowledge for Ageing (LINKAGE) [local site])\n\n
IRAS ID
164446
Contact name
Daniel Davis
Contact email
Sponsor organisation
UCL
Clinicaltrials.gov Identifier
Z6364106/2016/04/09, UCL Data Protection Registration number
Duration of Study in the UK
4 years, 0 months, 1 days
Research summary
Background\nDelirium is a syndrome of severe brain dysfunction caused by acute illness. It affects at least 1 in 8 hospitalised patients. Several studies show that delirium is linked with both high risk of new dementia, and worsening of existing dementia. This is extremely important because it suggests that targeting delirium may be a beneficial intervention in dementia prevention. Yet our understanding of the delirium-dementia relationship remains poor. Major gaps include:\n(i) Which delirium features (e.g. duration, severity, subtypes, causes) are associated with worse cognitive outcomes.\n\nMain Hypotheses\n(i) Greater delirium severity and/or duration results in higher rates of new dementia or worsening of existing dementia. Aims - This project will establish a new population-based sample – Delirium and Population Health Informatics (DELPHIC) Study. This will track cognitive function before, during and after hospitalisation in delirium cases and controls.\n\nThe DELPHIC delirium cohort\nWe will recruit a new population-based, age-stratified cohort of 2,000 individuals aged ≥70 years from the London Borough of Camden. Participants will undergo baseline cognitive assessments including the modified Telephone Interview for Cognitive Status (TICS-m). Participants will then be proactively monitored for episodes of delirium, via: (i) high-risk participant/informant contact; (ii) regular GP contact; (iii) daily screen of names of admissions to acute hospitals in Camden (University College and Royal Free Hospitals). Hospitalised participants will be assessed for delirium (diagnosis, duration, severity, subtype, associated clinical data) each day participants are admitted. We will then ascertain cognitive outcomes (TICS-m) in the whole-cohort at 2 years.\n\n\nOutcomes\nDELPHIC will be the first prospective population study relating delirium and its features to risk of incident dementia and worsening of prevalent dementia.\n\n\nMulti-site expansion\nThe DELPHIC study is now expanding to recruit to other sites. The same sampling procedures, ascertainment methods, and outcomes will be used. However, comparator sites will be established (initially in the NHS Herefordshire CCG / Wye Valley NHS Trust). Furthermore, special populations (e.g. surgical patients) will also be followed up under the DELPHIC framework even if they are recruited from outside the original Camden sampling frame (nationwide).[COVID-19 amendment 16/03/2020] DELPHIC already established as cohort resource, with unique opportunity to undertake work on epidemiological transmission with parallel serial sampling of pathophysiology.2) We propose urgent field work in the form of repeated home visits, up to weekly until the pandemic is established in London.\n3) We will incorporate offer testing and clinical advice using protocols in place in related settings.\n4) Principal scientific value is in acquiring pre-infected samples as a vital step for developing vaccines and/or novel treatments for COVID-19 and its complications.\n5) It complements the work of ISARIC (on inpatient cohort) but adds vital *context* on the pre-hospital population course of COVID-19.\n\n[COVID-19 amendment –30/04/2020]\n\n1) Currently DELPHIC-COVID is considered a substudy of the parent DELPHIC study. we would like to combine the participant-facing material to a single recruitment and consenting process.\n2) Minor amendments to the case report form\n3) In the previous review, a question was raised about the safe conduct of the study. Specifically, we set out to minimise any risk of SARS-CoV-2 transmission.
REC name
London - Camden & Kings Cross Research Ethics Committee
REC reference
16/LO/1217
Date of REC Opinion
20 Sep 2016
REC opinion
Further Information Favourable Opinion