Postoperative changes in cognition and cerebrospinal fluid neurodegenerative disease biomarkers.
Journal Article (Journal Article)
OBJECTIVE: Numerous investigators have theorized that postoperative changes in Alzheimer's disease neuropathology may underlie postoperative neurocognitive disorders. Thus, we determined the relationship between postoperative changes in cognition and cerebrospinal (CSF) tau, p-tau-181p, or Aβ levels after non-cardiac, non-neurologic surgery in older adults. METHODS: Participants underwent cognitive testing before and 6 weeks after surgery, and lumbar punctures before, 24 h after, and 6 weeks after surgery. Cognitive scores were combined via factor analysis into an overall cognitive index. In total, 110 patients returned for 6-week postoperative testing and were included in the analysis. RESULTS: There was no significant change from before to 24 h or 6 weeks following surgery in CSF tau (median [median absolute deviation] change before to 24 h: 0.00 [4.36] pg/mL, p = 0.853; change before to 6 weeks: -1.21 [3.98] pg/mL, p = 0.827). There were also no significant changes in CSF p-tau-181p or Aβ over this period. There was no change in cognitive index (mean [95% CI] 0.040 [-0.018, 0.098], p = 0.175) from before to 6 weeks after surgery, although there were postoperative declines in verbal memory (-0.346 [-0.523, -0.170], p = 0.003) and improvements in executive function (0.394, [0.310, 0.479], p < 0.001). There were no significant correlations between preoperative to 6-week postoperative changes in cognition and CSF tau, p-tau-181p, or Aβ42 changes over this interval (p > 0.05 for each). INTERPRETATION: Neurocognitive changes after non-cardiac, non-neurologic surgery in the majority of cognitively healthy, community-dwelling older adults are unlikely to be related to postoperative changes in AD neuropathology (as assessed by CSF Aβ, tau or p-tau-181p levels or the p-tau-181p/Aβ or tau/Aβ ratios). TRIAL REGISTRATION: clinicaltrials.gov (NCT01993836).
Full Text
Duke Authors
- Acker, Leah
- Amundsen, Cindy Louise
- Bennett, Ellen Ruth
- Berger, Miles
- Blazer III, Dan German
- Bolognesi, Michael Paul
- Brigman, Brian Eugene
- Browndyke, Jeffrey Nicholas
- Bullock, William Michael
- Colin, Brian Joseph
- DeOrio, James Keith
- Devinney, Michael
- Erdmann, Detlev
- Esclamado, Ramon Mitra
- Gadsden, Jeffrey Charles
- Habib, Ashraf Samir
- Hallows, Rhett Kendall
- Harpole Jr., David Harold
- Hartwig, Matthew
- Hollenbeck, Scott Thomas
- Iboaya, Ehimemen
- Inman, Brant Allen
- Jang, David W
- Laskowitz, Daniel Todd
- Lee, Walter T
- Levinson, Howard
- Lipkin, Michael Eric
- Mantyh, Christopher Ritchie
- Martucci, Katherine
- Mathew, Joseph P.
- Migaly, John
- Mithani, Suhail Kamrudin
- Moretti, Eugene William
- Mosca, Paul Joseph
- Moul, Judd Wendell
- Peterson, Andrew Charles
- Polascik, Thomas James
- Preminger, Glenn Michael
- Robertson, Cary Nobles
- Runyon, Scott Lawrence
- Scales Jr., Charles Douglas
- Scheri, Randall Paul
- Tong, Betty Caroline
- Vaslef, Steven Nicholas
- Wellman, Samuel S.
- Whitson, Heather Elizabeth
- Woldorff, Marty G.
- Young, Christopher Carlo
- Zani Jr., Sabino
Cited Authors
- Berger, M; Browndyke, JN; Cooter Wright, M; Nobuhara, C; Reese, M; Acker, L; Bullock, WM; Colin, BJ; Devinney, MJ; Moretti, EW; Moul, JW; Ohlendorf, B; Laskowitz, DT; Waligorska, T; Shaw, LM; Whitson, HE; Cohen, HJ; Mathew, JP; MADCO-PC Investigators,
Published Date
- February 2022
Published In
Volume / Issue
- 9 / 2
Start / End Page
- 155 - 170
PubMed ID
- 35104057
Pubmed Central ID
- PMC8862419
Electronic International Standard Serial Number (EISSN)
- 2328-9503
Digital Object Identifier (DOI)
- 10.1002/acn3.51499
Language
- eng
Conference Location
- United States