Sharon Inouye MD
Professor (Adjunct) of Medicine (General Medicine)
Delirium, Dementia, Alzheimer's Disease, Acute Confusional State, Geriatric Medicine, Aging Research, Hospital Elder Life Program, Patient Safety, Iatrogenesis
Dr. Inouye’s groundbreaking research work has focused on delirium and functional decline in hospitalized older patients, resulting in over 70 published articles to date. Her overarching goal has been to translate clinical investigation from its theoretical basis to practical applications that will improve clinical care and quality of life for older persons. Her work has involved applying rigorous clinical epidemiologic and clinical trial methodology to advance the scientific understanding of the diagnosis, etiology, prognosis, prevention, and treatment of delirium. Early in her career, she developed and validated a new instrument for identification of delirium, the Confusion Assessment Method (CAM), which is now the most widely used standard in the field, translated into at least 6 languages. Subsequently, Dr. Inouye helped to conceptualize the multifactorial model for delirium, and focused on identification of predisposing and precipitating factors for delirium. Finally, she developed a multicomponent intervention strategy to prevent delirium, targeted towards six delirium risk factors. This strategy—published in a landmark study in the New England Journal of Medicine—was successful in reducing delirium by 40%, demonstrating for the first time that a substantial proportion of delirium is preventable. A recent study in Medical Care has demonstrated the cost-effectiveness of this intervention strategy. The intervention, called the Hospital Elder Life Program (HELP), is now undergoing national dissemination. Currently, Dr. Inouye is conducting a study examining the pathophysiology of delirium, utilizing neuroimaging (single photon emission computed tomography, SPECT), laboratory markers (e.g., neuron specific enolase and others), and neuropsychological test results—during and after a delirium episode. Other active research areas include the investigation of the long–term outcomes and economic implications of the delirium prevention program, development of strategies for prevention of delirium in the ICU, and development of new screening methods for dementia.