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Cognitive and Cerebrospinal Fluid Alzheimer's Disease-related Biomarker Trajectories in Older Surgical Patients and Matched Nonsurgical Controls.

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Reese, M; Wong, MK; Cheong, V; Ha, CI; Cooter Wright, M; Browndyke, J; Moretti, E; Devinney, MJ; Habib, AS; Moul, JW; Shaw, LM; Waligorska, T ...
Published in: Anesthesiology
May 1, 2024

BACKGROUND: Anesthesia and/or surgery accelerate Alzheimer's disease pathology and cause memory deficits in animal models, yet there is a lack of prospective data comparing cerebrospinal fluid (CSF) Alzheimer's disease-related biomarker and cognitive trajectories in older adults who underwent surgery versus those who have not. Thus, the objective here was to better understand whether anesthesia and/or surgery contribute to cognitive decline or an acceleration of Alzheimer's disease-related pathology in older adults. METHODS: The authors enrolled 140 patients 60 yr or older undergoing major nonneurologic surgery and 51 nonsurgical controls via strata-based matching on age, sex, and years of education. CSF amyloid β (Aβ) 42, tau, and p-tau-181p levels and cognitive function were measured before and after surgery, and at the same time intervals in controls. RESULTS: The groups were well matched on 25 of 31 baseline characteristics. There was no effect of group or interaction of group by time for baseline to 24-hr or 6-week postoperative changes in CSF Aβ, tau, or p-tau levels, or tau/Aβ or p-tau/Aβ ratios (Bonferroni P > 0.05 for all) and no difference between groups in these CSF markers at 1 yr (P > 0.05 for all). Nonsurgical controls did not differ from surgical patients in baseline cognition (mean difference, 0.19 [95% CI, -0.06 to 0.43]; P = 0.132), yet had greater cognitive decline than the surgical patients 1 yr later (β, -0.31 [95% CI, -0.45 to -0.17]; P < 0.001) even when controlling for baseline differences between groups. However, there was no difference between nonsurgical and surgical groups in 1-yr postoperative cognitive change in models that used imputation or inverse probability weighting for cognitive data to account for loss to follow up. CONCLUSIONS: During a 1-yr time period, as compared to matched nonsurgical controls, the study found no evidence that older patients who underwent anesthesia and noncardiac, nonneurologic surgery had accelerated CSF Alzheimer's disease-related biomarker (tau, p-tau, and Aβ) changes or greater cognitive decline.

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Published In

Anesthesiology

DOI

EISSN

1528-1175

Publication Date

May 1, 2024

Volume

140

Issue

5

Start / End Page

963 / 978

Location

United States

Related Subject Headings

  • tau Proteins
  • Peptide Fragments
  • Humans
  • Cognitive Dysfunction
  • Cognition
  • Biomarkers
  • Anesthesiology
  • Amyloid beta-Peptides
  • Alzheimer Disease
  • Aged
 

Citation

APA
Chicago
ICMJE
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Reese, M., Wong, M. K., Cheong, V., Ha, C. I., Cooter Wright, M., Browndyke, J., … Markers of Alzheimer’s Disease and neuroCognitive Outcomes after Perioperative Care (MADCO-PC) Investigators, . (2024). Cognitive and Cerebrospinal Fluid Alzheimer's Disease-related Biomarker Trajectories in Older Surgical Patients and Matched Nonsurgical Controls. In Anesthesiology (Vol. 140, pp. 963–978). United States. https://doi.org/10.1097/ALN.0000000000004924
Reese, Melody, Megan K. Wong, Vanessa Cheong, Christine I. Ha, Mary Cooter Wright, Jeffrey Browndyke, Eugene Moretti, et al. “Cognitive and Cerebrospinal Fluid Alzheimer's Disease-related Biomarker Trajectories in Older Surgical Patients and Matched Nonsurgical Controls.” In Anesthesiology, 140:963–78, 2024. https://doi.org/10.1097/ALN.0000000000004924.
Reese M, Wong MK, Cheong V, Ha CI, Cooter Wright M, Browndyke J, et al. Cognitive and Cerebrospinal Fluid Alzheimer's Disease-related Biomarker Trajectories in Older Surgical Patients and Matched Nonsurgical Controls. In: Anesthesiology. 2024. p. 963–78.
Reese, Melody, et al. “Cognitive and Cerebrospinal Fluid Alzheimer's Disease-related Biomarker Trajectories in Older Surgical Patients and Matched Nonsurgical Controls.Anesthesiology, vol. 140, no. 5, 2024, pp. 963–78. Pubmed, doi:10.1097/ALN.0000000000004924.
Reese M, Wong MK, Cheong V, Ha CI, Cooter Wright M, Browndyke J, Moretti E, Devinney MJ, Habib AS, Moul JW, Shaw LM, Waligorska T, Whitson HE, Cohen HJ, Welsh-Bohmer KA, Plassman BL, Mathew JP, Berger M, Markers of Alzheimer’s Disease and neuroCognitive Outcomes after Perioperative Care (MADCO-PC) Investigators. Cognitive and Cerebrospinal Fluid Alzheimer's Disease-related Biomarker Trajectories in Older Surgical Patients and Matched Nonsurgical Controls. Anesthesiology. 2024. p. 963–978.

Published In

Anesthesiology

DOI

EISSN

1528-1175

Publication Date

May 1, 2024

Volume

140

Issue

5

Start / End Page

963 / 978

Location

United States

Related Subject Headings

  • tau Proteins
  • Peptide Fragments
  • Humans
  • Cognitive Dysfunction
  • Cognition
  • Biomarkers
  • Anesthesiology
  • Amyloid beta-Peptides
  • Alzheimer Disease
  • Aged