About

Lori Daiello, PharmD, ScM, is an Associate Professor of Health Services, Policy and Practice (Research) and Neurology (Research) at Brown University. She is a cognitive aging researcher with primary interests in novel biomarkers of neurodegeneration, preclinical Alzheimer's Disease, delirium, and perioperative neurocognitive disorders. Her work is informed by a long-standing interest in the impact of prescription medications on late-life cognitive and functional outcomes, collaborating with colleagues at the School of Public Health and the Department of Psychiatry and Human Behavior. Dr. Daiello is the principal investigator of an NIH-funded study examining postoperative delirium and persistent cognitive impairment among older adults undergoing major surgeries. Her research utilizes brain MRI and other measures to investigate blood-brain barrier dysfunction and neuroinflammation as mediators of perioperative cognitive disorders and the risk of late-onset Alzheimer's Disease. Her affiliations include the Department of Health Services, Policy and Practice, and the Department of Neurology at Brown University, with research areas spanning Alzheimer's disease, dementia, brain health, medication adverse effects, and geriatric psychopharmacology.

Research topics

• Medicine
• Internal medicine
• Psychology
• Pathology
• Neuroscience
• Psychiatry
• Oncology
• Machine Learning
• Computer Science
• Artificial Intelligence
• Theoretical computer science
• Econometrics
• Nuclear medicine
• Audiology
• Biology
• Mathematics
• Data science
• Chemistry

Selected publications

• Subjective and objective cognition in early-stage, treatment-naïve Parkinson’s disease: Relationships with mood.

  Neuropsychology · 2026-05-11

  article

  OBJECTIVE: Subjective cognitive complaints (SCCs) are common in Parkinson's disease (PD), yet the relationship among nonmotor symptoms remains understudied in early-stage, treatment-naïve populations. We examined interrelationships among SCCs, mood symptoms, and cognition in early-stage, treatment-naïve PD. We hypothesized that SCCs would relate to executive functioning and processing speed, and these relationships would be moderated by mood. METHOD: tests and Pearson correlations assessed associations among SCC group status, mood symptoms, and cognition. Ordinary least squares regression evaluated whether mood moderated the relationship between SCC group status and cognition. RESULTS: s < .05). No other mood moderation effects were found. CONCLUSIONS: In early-stage, treatment-naïve PD, more SCCs corresponded with worse mood symptoms and worse processing speed and memory. Memory performance was worse when both higher SCCs and elevated state anxiety are present, but mood did not moderate higher SCCs' relationship with other domains. SCCs may be early indication of neurocognitive vulnerability. Longitudinal research is warranted to determine how mood symptoms impact SCCs' utility for predicting cognitive decline. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

  PublisherDOI

• Impact of national partnership to improve dementia care on antipsychotic use duration for dementia residents in nursing homes

  The Journals of Gerontology Series A · 2026-02-26

  articleOpen access

  BACKGROUND: Federal policies have successfully targeted the prevalence of antipsychotic (AP) exposure in NHs, but the duration of treatment among nursing home (NH) residents has not been reported. We evaluated AP duration and discontinuation within six months in residents with dementia. METHODS: Retrospective cohort study of long-stay NH residents with dementia who newly initiated an AP medication. We evaluated changes in AP duration and discontinuation within six months relative to two federal initiatives: National Partnership to Improve Dementia Care (2012) and inclusion of AP use measures in the NH Star Ratings (2015). We accounted for resident and facility characteristics in a competing-risks analysis establishing the relationship between the two policy periods and AP outcomes. RESULTS: There were 43 668 new episodes of AP initiation among 38 275 residents. The duration of treatment within six months declined from 125.9 days in the pre-Partnership period to 120.5 days and 120.6 days in the post-Partnership and post-Five Star periods, respectively. Those who initiated APs after the Partnership [adjusted hazard ratio (aHR) = 1.17; confidence interval, 1.10-1.24] and after the Five Star Rating change (aHR = 1.19; 95% CI, 1.07-1.32) policy periods were more likely to stop the medication within 6 months as compared to those who initiated during the prior period. CONCLUSIONS: Federal policies designed to reduce AP prescribing in NH residents with dementia had a nominal impact on treatment duration within the first six months, with more than half continuing treatment beyond 6 months.

  PublisherDOI

• Falls in the Nursing Home: The Impact of Staffing Levels and Agency Staff Use on Injurious Falls

  Journal of the American Medical Directors Association · 2026-01-28

  articleOpen access
  PublisherOA PDFDOI

• RNA transcripts in salivary extracellular vesicle cargo isolated from aged populations

  Frontiers in Aging · 2026-01-12 · 1 citations

  articleOpen access

  Introduction: Human saliva contains numerous factors, including DNA, RNA, and protein, that may reflect the health status of the individual. Many of these factors are contained within extracellular vesicles (EVs). The contents of EVs are thought to mirror the cytoplasm of the cell of origin, providing insight into the health of the cell. We investigated the RNA content from EVs isolated from saliva (salEVs) to determine if we could detect transcripts associated with neurodegenerative conditions. Methods: We characterized the RNA cargo of salEVs isolated from individuals over the age of 65 with normal cognition. The salEV RNA content was analyzed by RNA-seq and NanoString miRNA analysis. Results: We found approximately 48.4% of the reads mapped to the human genome, with the remainder mapping to prokaryotic genomes. The transcripts included protein-coding RNA, long non-coding RNA, retrotransposons, and miRNAs. A significant number of the protein-coding transcripts were associated with pathways involved in neurodegenerative conditions. In addition, there was an enrichment of transcripts containing AP-2ε, HEYL, HES4, and TCFL5 transcription factor binding sites. We found that the lncRNA content was similar between samples, with PCBP1-AS1, TEX41, and PVT1 being the top represented transcripts. There were 286 miRNAs found in the salEV samples. The pathways predicted to be affected by the top represented miRNAs include Hippo signaling, TGF-β signaling, Wnt signaling, FoxO signaling, ErbB signaling, axon guidance, and mTOR signaling. We could detect retrotransposon transcripts from LINE, SINE, and LTR elements in salEVs. When compared to blood-derived EVs, salEVs showed greater representation of transcripts associated with neurodegenerative pathways. Discussion: Our results indicate that salEVs contain transcripts that are associated with pathways involved in neurodegeneration. The presence of these transcripts in salEVs suggest that saliva may be used to screen for biomarkers of neurodegenerative diseases.

  PublisherOA PDFDOI

• High Anticholinergic Burden of Patients Hospitalized for Hip Fracture Reveals a Target for Deprescribing

  Journal of the American Medical Directors Association · 2025-03-21 · 2 citations

  articleOpen access
  PublisherOA PDFDOI

• Medication adherence feedback with older adults with cognitive impairment: A mixed methods study

  The Clinical Neuropsychologist · 2025-01-09 · 1 citations

  article

  Adherence monitoring with feedback is feasible and impactful in cognitively impaired older adults. Increasing awareness of medication-taking errors fosters motivation to improve medication self-management and results in participant-reported behavior change.

  PublisherDOI

• Identifying observable medication use time in administrative databases: a tutorial using nursing home residents

  American Journal of Epidemiology · 2025-10-09 · 2 citations

  articleOpen access

  Nursing home (NH) residents are an important population for pharmacoepidemiologic research due to their prevalence of multimorbidity and polypharmacy. Medicare claims are commonly used to study medication use in this population, but medications dispensed during hospitalizations or post-acute care are unobservable due to bundled payment structures. We developed algorithms to identify NH days when medication dispensings can be observed in claims. Using a cohort of NH residents in the United States from 2013 to 2020, we linked Medicare fee-for-service (FFS) claims with Minimum Data Set clinical assessments. NH days were classified as "observable medication use time" if residents were enrolled in Medicare parts A, B, and D were not receiving post-acute care and were not hospitalized. Among 12.3 million NH residents and 2.7 billion NH days, 1.1 billion days (72.4% of Medicare-enrolled days and 39.6% of all NH days) were identified as observable medication use time. Within the first 100 days of NH admission, 27.3% of days were medication-observable, increasing to 89.4% after 100 days. On average, we identified 68% more person-time, and 51% more residents, compared to standard 100-day definitions for "long-stay" NH residents. Our algorithms enhance researchers' ability to measure medication exposure time, improving the validity of pharmacoepidemiologic studies.

  PublisherDOI

• Corrigendum to “Level of consciousness at discharge and associations with outcome after ischemic stroke” [Journal of the Neurological Sciences, Volume 390 (2018): 102–107]

  Journal of the Neurological Sciences · 2025-11-20

  articleOpen access
  PublisherOA PDFDOI

• Prevalence and Duration of Potential Drug–Drug Interactions Among <scp>US</scp> Nursing Home Residents, 2018–2020

  Journal of the American Geriatrics Society · 2025-10-17

  articleOpen access

  BACKGROUND: Nursing home (NH) residents are at increased risk of drug-drug interactions (DDIs) due to multimorbidity and polypharmacy. While prior research suggests that many DDIs lead to adverse drug events in older adults, the extent of exposure to potentially clinically relevant DDIs among United States (US) NH residents is largely unknown. METHODS: In this cohort study, we calculated the prevalence and duration of exposure to 98 potential DDIs among US NH residents from 2018 to 2020. DDIs were sourced from three expert consensus publications, some of which defined similar interactions and overlapping drug combinations, allowing comparisons within and across lists. Data were drawn from Medicare claims linked to Minimum Data Set 3.0 clinical assessments. Eligible residents included Medicare Fee-for-Service beneficiaries aged ≥ 66 years living in NHs with observable Part D prescription drug data. DDI exposure was defined as ≥ 1 day of concurrent use of orally administered medications. Prevalence was calculated as the proportion of residents exposed to each DDI; duration was measured as the median number of days residents concurrently used the medications of interest. RESULTS: Among 485,251 NH residents, 61.6% experienced ≥ 1 potential DDI over 272,780 person-years. The 12 most prevalent DDIs involved central nervous system (CNS)-active drugs, anticholinergics, antihypertensives, opioids, and diuretics. Of these DDIs, concurrent use of acetylcholinesterase inhibitors and heart rate-reducing drugs had the longest median exposure duration (81 days; Q1-Q3, 24-235). The most prevalent DDI, concomitant use of ≥ 3 CNS-active drugs, was observed in 27.1% (95% CLs, 27.0%, 27.2%) of residents. CONCLUSIONS: Nearly two-thirds of NH residents were exposed to medication combinations linked to potential DDIs, although the prevalence and duration of exposure associated with individual DDIs varied. Future research should determine which DDIs are most clinically significant and investigate barriers to reducing exposure duration in this high-risk population.

  PublisherOA PDFDOI

• From Acute Confusion to Chronic Decline: The Cognitive Impact of Delirium in Older Adults.

  PubMed · 2025-05-01

  reviewSenior author

  Delirium is prevalent in healthcare settings, leaving susceptible older adults at risk for persistent cognitive impairment, prolonged care needs, morbidity, and mortality. In older adult patients, delirium often arises from acute medical illnesses, infections, medications, and comorbidities, with age and underlying dementia increasing susceptibility. Its complex pathophysiology involves systemic inflammation, neurotransmitter dysregulation, disrupted brain metabolism, and physiological cycle disturbances. While delirium causes acute cognitive impairments, patients are often left with persistent dysfunction. Moreover, patients with pre-existing cognitive impairment are at higher risk for developing dementia or accelerated cognitive decline in the wake of a delirium episode. Delirium also worsens long-term quality of life, increasing risk for functional disability and need for institutional care. Prevention and management strategies focus on prophylaxis, early intervention, multicomponent programs, and pharmacological interventions, while ongoing research seeks to identify biomarkers and improve delirium detection and long-term management.

  Publisher

Recent grants

• NIH Grant R03AG050232

  NIH · $177k · 2018

• Blood-Brain Barrier Disruption as a Biomarker for Perioperative Neurocognitive Disorder:Cognitive Recovery after Elective Surgery

  NIH · $4.2M · 2019–2026

• NIH Grant K08HS017735

  NIH · $754k · 2014

Frequent coauthors

• Brian R. Ott

  Brown University

  217 shared

• Andrew R. Zullo

  Brown University

  177 shared

• Jonathan Drake

  Alzheimer’s Disease Neuroimaging Initiative

  121 shared

• Sarah D. Berry

  Hebrew SeniorLife

  115 shared

• Richard N. Jones

  Butler Hospital

  109 shared

• Douglas P. Kiel

  Hebrew SeniorLife

  100 shared

• Geoffrey Tremont

  Providence College

  75 shared

• Seth A. Margolis

  Brown University

  70 shared

Education

• Other, Pharmacy

  Brown University

• Other, Public Health

  Brown University