Faculty
Lori Daiello
, PharmD
Assistant Professor of Neurology (Research):
Bio Med Neurology
Phone: +1 401 444 3337
Lori_Daiello@brown.edu
Read Lori Daiello's full Faculty Research Profile.
Research Interests
Comprehensive knowledge of the comparative risks and benefits associated with the use or discontinuation of psychopharmacologic medications in patients with dementia and complex medical illness is often not possible due to the knowledge gaps that exist in the field of geriatric pharmacology. My research explores how medications affect the trajectory of decline in cognitive and functional abilities and the development of neuropsychiatric symptoms in progressive degenerative dementias.
Biography
Lori Daiello is an Assistant Professor of Neurology (Research) at The Warren Alpert Medical School of Brown University. She is a PharmD whose research focuses on psychopharmacology, pharmacoepidemiology, and geriatric cognitive disorders. She completed her training at The Ohio State University College of Pharmacy and went on to develop clinical psychopharmacology practices in Ohio and Florida. In 2006, she came to Brown to complete a T32 Dementia Research Fellowship. After completing her research fellowship, she joined the Department of Neurology and the Alzheimer's Disease and Memory Disorders Center at Rhode Island Hospital. Her current research includes studies funded by the Agency for Healthcare Research and Quality that aim to enhance understanding of how the use or discontinuation of psychoactive medications impacts cognitive, functional, and behavioral symptom domains in dementia and the effects of inhaled anesthetics on the trajectory of cognitive decline in persons with pre-existing cognitive disorders
Interests
Dementia is a chronic illness. Individuals with AD may live years beyond diagnosis with increasing levels of cognitive and functional dependence. Interventions such as medication therapy and surgical procedures may achieve therapeutic or palliative goals of care or may be associated with increased disability in cognitively impaired, medically and pharmacologically complex patients. For most medications and other interventions, geriatric data are sparse in short-term randomized controlled trials (RCT); even less information is available for longitudinal treatment outcomes. Well-designed observational studies can elucidate how well a given intervention works when used by a typical clinician under usual treatment conditions and can help bridge the evidence gaps for populations for which RCT are not feasible. Comparative effectiveness studies that compare short or longer-term alternate treatment strategies can provide important information to inform patient care and health care policy for groups underrepresented or excluded from RCT such as frail, cognitively impaired elderly patients who reside in nursing homes.
My research aims are 1) To explore the longitudinal neurobehavioral, cognitive, and functional effects of discontinuing CHEIs compared to continuous long term CHEI therapy in nursing facility residents with dementia and to determine, and 2) To determine if cognitively impaired patients receiving certain isoflurane general anesthesia during surgery experience greater post-operative cognitive and functional decline in the year after surgery compared to patients receiving other types of general anesthesia. A focus of my career development award is conducting observational comparative effectiveness studies that utilize state-of-the-art analytic methods and automated cross-linked Medicare and Medicaid claims datasets.