Developing postoperative delirium is associated with a faster rate of cognitive decline

Study highlights the importance of delirium prevention to preserve brain health in older adults who undergo surgery

2023-03-20

(Press-News.org) BOSTON, MA -- Research published today in the JAMA Internal Medicine finds that developing postoperative delirium is associated with a 40% faster rate of cognitive decline over those who do not develop delirium.

“Delirium is associated with faster cognitive decline,” said Zachary J. Kunicki, PhD, MS, MPH Assistant Professor located at the Warren Alpert Medical School of Brown University, the first author. “Whether delirium causes this faster rate of decline, or is simply a marker of those who are at risk of experiencing faster rates of decline, is still to be determined.”

“This study has the longest follow-up period of any study examining persons with delirium following surgery,” said Sharon K. Inouye, MD, MPH Director, Aging Brain Center, Hinda and Arthur Marcus Institute for Aging Research, the senior author and principal investigator on the work. “While future studies are needed, this study raises the possibility that delirium may predispose to permanent cognitive decline and potentially dementia. This highlights the importance of delirium prevention to preserve brain health in older adults who undergo surgery,” she said.

Delirium is the most common post-operative complication in older adults and is associated with poor outcomes, including long-term cognitive decline and incident dementia.

Richard N. Jones, ScD, Warren Alpert Medical School of Brown University is co-Senior Author of the article, “Six-year cognitive trajectory in older adults following major surgery and delirium.” Inouye is the Overall Principal Investigator of the SAGES Study (NIH Grant No. P01AG031720) that funded this long-term observational study.

The SAGES cohort has followed 560 older adults (age 70 and older), measuring their cognition every 6 months for 36 months, then annually afterwards for up to 6 years. Using a detailed cognitive testing battery, comprised of 11 different tests, we found that cognitive changes after surgery are complex and that delirium influences every timepoint. The average cognitive changes seen after surgery include an abrupt drop at one month after surgery, an increase at two months after surgery, a stable period from 6-30 months after surgery, and then steady decline from 3-6 years after surgery. Delirium is associated with a sharper drop at 1 month, greater recovery at 2 months, and faster decline in all time periods from 6 months to 6 years, respectively. The results suggest that either delirium itself may contribute to cognitive decline after surgery, or that delirium may serve to identify those at risk for future more rapid cognitive decline. Future research will be needed to examine whether either or both of these hypotheses best explain the relationship between delirium and cognitive decline.

Collaborating institutions are Warren Alpert Medical School of Brown University; Beth Israel Deaconess Medical Center; Harvard Medical School; and the University of Maryland.

The study was supported by Grants No. P01AG031720 (S.K.I.), R33AG071744 (S.K.I./R.N.J.), R01AG044518 (S.K.I./R.N.J.) from the National Institute on Aging.

About the Hinda and Arthur Marcus Institute for Aging Research
Scientists at the Marcus Institute seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity, and productivity into advanced age. The Marcus Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment, and cure of disease; advance the standard of care for older people; and inform public decision-making.

About Hebrew SeniorLife
Hebrew SeniorLife, an affiliate of Harvard Medical School, was founded in 1903 and today is a national leader dedicated to empowering seniors to live their best lives. Hebrew SeniorLife cares for more than 3,000 seniors a day across six campuses throughout Greater Boston. Locations include: Hebrew Rehabilitation Center-Boston and Hebrew Rehabilitation Center-NewBridge in Dedham; NewBridge on the Charles, Dedham; Orchard Cove, Canton; Simon C. Fireman Community, Randolph; Center Communities of Brookline; and Jack Satter House, Revere. Hebrew SeniorLife also trains more than 1,000 future health care professionals each year, and conducts influential research into aging at the Hinda and Arthur Marcus Institute for Aging Research, which has a robust research portfolio whose NIH funding in 2021 places it in the top 10% of NIH-funded institutions. For more information about Hebrew SeniorLife, visit our website or follow us on our blog, Facebook, Instagram, Twitter, and LinkedIn.

About the Warren Alpert Medical School
The Warren Alpert Medical School is the medical school of Brown University, located in Providence, Rhode Island, United States. Established in 1811, the school was among the first in the nation to offer academic medical education. Today, Alpert Medical School is a component of Brown’s Division of Biology and Medicine, which also includes the Program in Biology. (A third component of the Division, the Program in Public Health, became the Brown University School of Public Health on July 1, 2013.) Together with the Medical School’s seven affiliated teaching hospitals, the Division attracts over $240 million in external research funding per year. The fourth most selective medical school in the United States, Alpert Medical School earned rankings of twenty-fourth for primary care education and thirty-first for research in the 2014 U.S. News & World Report rankings. Graduates of Alpert Medical School are accepted into competitive residency programs and leading medical centers.

END

ELSE PRESS RELEASES FROM THIS DATE:

Daily step counts before, after onset of COVID-19

2023-03-20

About The Study: The findings of this study suggest a consistent, widespread, and significant decline in activity following the onset of COVID-19 in the United States. Vulnerable populations, including individuals at a lower socioeconomic status and those reporting worse mental health in the early COVID-19 period, were at the highest risk of reduced activity. The researchers found a significant decline in daily step counts that persisted even after most COVID-19–related restrictions were relaxed, suggesting COVID-19 affected long-term behavioral choices. It is currently unknown whether this reduction is steps is clinically meaningful over time. Authors: Evan L. ...

Gender disparity in NIH funding among surgeon-scientists

2023-03-20

About The Study: The results of this study of National Institutes of Health (NIH)-funded surgeons suggest that women surgeons remained underrepresented among surgeon-scientists over a 25-year period despite early career success in receiving NIH funding. These findings suggest that substantial additional support for women surgeon-scientists is necessary to achieve a gender-diverse surgical research workforce. Authors: Mytien Nguyen, M.S., of the Yale School of Medicine in New Haven, Connecticut, is the corresponding author. To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/ (doi:10.1001/jamanetworkopen.2023.3630) Editor’s ...

Patients overwhelmingly prefer immediate access to test results, even when the news may not be good

2023-03-20

BOSTON – In April 2021, new federal rules went into effect mandating that healthcare providers make nearly all test results and clinical notes immediately available to patients. Evidence suggests that patients may gain important clinical benefits by reviewing their medical records, and access through electronic patient portals has been advocated as a strategy for empowering patients to manage their health care and for strengthening patient-clinician relationships. However, concerns remain about the effects of releasing test results to patients before clinicians offer counsel or interpretation. In ...

PLOS announces newest joiners to the CRL/NERL Agreement

2023-03-20

SAN FRANCISCO – The Public Library of Science (PLOS) welcomes several new participants to its ongoing three-year consortial agreement with Center for Research Libraries (CRL) and the Northeast Research Libraries (NERL) program. Joining twenty fellow member institutions who signed on during the first year, newly participating institutions for the second year include Duke University, Macalester College, University of Arizona, University of Denver, and University of Southern California, University of Texas at Austin, and University of Washington. This agreement provides researchers with unlimited publishing privileges in PLOS journals without incurring fees. All PLOS journals are underpinned ...

Link between chronic kidney disease and cardiovascular disease explained

2023-03-20

Researchers from Tokyo Medical and Dental University (TMDU) have uncovered a link between cardiovascular disease and chronic kidney disease, revealing novel disease biomarkers and therapeutic targets Tokyo, Japan – Chronic kidney disease is linked to the formation of mineral deposits on blood vessel walls, known as “calcification”, causing cardiovascular disease. Small extracellular vesicles (sEVs)—small, enclosed structures outside cells—can transmit signaling molecules between cells, but their biological roles are not fully understood. Now, “malicious” sEVs ...

We have better solutions than chemical warfare to tackle climate-related pests and diseases

2023-03-20

Published on 10 March 2023 in Agronomy journal, the TMG Research gGmbH study team traced a highly destructive desert locust invasion in the Eastern Africa and Horn region between 2019-2021. Ethiopia and Kenya sprayed well over a million hectares of territory with damaging nerve agents malathion and chlorpyrifos, both from the organophosphate family of pesticides. The scale of the invasion – and subsequent choice of control measures – was magnified by unprecedented breeding due to changing climate conditions. Due to the inaccessible location of the breeding grounds, the scale of the threat ...

Discover BMB 2023 press materials available now

2023-03-20

Embargoed press materials are now available for Discover BMB, the annual meeting of the American Society for Biochemistry and Molecular Biology. Top scientists and educators in the field will gather at the meeting, held March 25–28 in Seattle. Reporters are invited to attend an exciting lineup of in-person scientific sessions in Seattle or access press materials electronically. Register now or find more information in the #DiscoverBMB newsroom. Explore the schedule at a glance, full program, award lectures, or symposium sessions to see all the exciting research topics that will be covered at #DiscoverBMB. Featured research findings are highlighted below: New ...

Spherical particles growth with dynamics oscillation during lithium electrodeposition：Insights from numerical simulations

2023-03-20

They published their work on Feb. 6 in Energy Material Advances. “Lithium-ion batteries are considered one of the most promising next-generation energy storage technologies,” said paper author Hui Xing, associate professor with MOE Key Laboratory of Material Physics and Chemistry under Extraordinary, Northwestern Polytechnical University. “to fully understand the dynamics of lithium dendrite growth during electrodeposition to inhibit the growth of lithium dendrite structure has been important in the field of battery safety and energy storage.” Xing explained that Previous ...

Upgraded tumor model optimizes search for cancer therapies

2023-03-20

HOUSTON – (March 20, 2023) – Tumor cells won’t show their true selves in a petri dish, isolated from other cells. To find out how they really behave, Rice University researchers developed an upgraded tumor model that houses osteosarcoma cells beside immune cells known as macrophages inside a three-dimensional structure engineered to mimic bone. Using the model, bioengineer Antonios Mikos and collaborators found that the body’s immune response can make tumor cells ...

Personality, satisfaction linked throughout adult lifespan

2023-03-20

Certain personality traits are associated with satisfaction in life, and despite the changes people may experience in social roles and responsibilities over the course of their adult lives, that association is stable regardless of age, according to research published by the American Psychological Association. “Many studies have shown that people with certain personality profiles are more satisfied with their life than others. Yet, it had not been extensively studied whether this holds true across the lifespan. For example, extraverted – that is sociable, talkative – people might be particularly happy in young adulthood, ...

Developing postoperative delirium is associated with a faster rate of cognitive decline

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: