SREMI Research Chair

The impact of the inaugural SREMI Research Chair in Geriatric Emergency Medicine continues to grow. As highlighted below, SREMI’s support for the Research Chair has enabled the expansion of crucial research into social isolation and loneliness, using powerful basic science techniques like metabolomics to better understand delirium, the incorporation of technology and artificial intelligence to improve outcomes for older people who need emergency care and new national and international mentorship and collaborations.

Social Isolation and Loneliness

Social Isolation and Loneliness contributes to 45,000 deaths per year in Canada and continues to be one of the largest social determinants of health for which there is no commonly accepted treatment. Dr. Lee is leading a team of dedicated, bright research assistants and volunteers to implement and test an intervention to combat social isolation known as HOW-RU? (HOspitals WoRrking in Unison). HOW-RU? connects lonely older people discharged from the ED with hospital volunteers.

As of October 2023, the study has screened over 4,000 older people and enrolled 89% of the required participants, with completion of enrollment anticipated by the end of 2023. Recently, University of Ottawa medical student Jacky Lee completed over 120 qualitative interviews to understand participants’ experience with the HOW RU? interventions, and to learn was to improve the intervention.

Results should be available by March 2024. If the results are successful as anticipated, the HOW RU intervention offers great promise as a low-cost, scalable intervention that can be expanded to 90% of Canadian hospitals that have volunteer services.

Ongoing Research and New Directions

Dr. Lee’s main research focus is delirium, a poorly understood and deadly condition that most affects older people. After 400 years, the underlying processes in the brain that lead to delirium are still not understood. Over a decade, Dr. Lee develop a network of hospitals across Canada that have the capacity to conduct research on older ED patients. With this network and an $850,000 grant from the Canadian Institutes of Health Research, over the next 5 years Dr. Lee and his team will conduct fundamental research on what happens in the brains of older people when they develop delirium. Having enrolled 40 pilot patients at one center in 2023, enrollment will expand to 3 centers by March 2024, with a final goal of 610 participants by the end of the 5 years. This study has the potential to develop a simple urine test to detect impending delirium in older people with hip fractures, as well as providing fundamental insights into the pathophysiology of delirium that may provide novel treatments and prevention strategies.

Training the Next Generation of Leaders

Dr. Lee supervised Sara Corvinelli, who completed her MSc. thesis in July 2023. Delirium can be classified as “hyperactive delirium”, characterized by agitation and restlessness, and “hypoactive delirium” marked by excessive sedation and difficulty arousing patients. Ms. Corvinelli’s thesis examined tools to measure these two subtypes of delirium and she discovered important inconsistency with these tools that brings previous research into question. Ms. Corvinelli is continuing her research with the goal of developing better measurement tools.