Relationship between cortical brain atrophy, delirium, and long-term cognitive decline in older surgical patients.
Neurobiol Aging
; 140: 130-139, 2024 Aug.
Article
en En
| MEDLINE
| ID: mdl-38788524
ABSTRACT
In older patients, delirium after surgery is associated with long-term cognitive decline (LTCD). The neural substrates of this association are unclear. Neurodegenerative changes associated with dementia are possible contributors. We investigated the relationship between brain atrophy rates in Alzheimer's disease (AD) and cognitive aging signature regions from magnetic resonance imaging before and one year after surgery, LTCD assessed by the general cognitive performance (GCP) score over 6 years post-operatively, and delirium in 117 elective surgery patients without dementia (mean ageâ¯=â¯76). The annual change in cortical thickness was 0.2(1.7)â¯% (AD-signature pâ¯=â¯0.09) and 0.4(1.7)â¯% (aging-signature pâ¯=â¯0.01). Greater atrophy was associated with LTCD (AD-signature beta(CI)â¯=â¯0.24(0.06-0.42) points of GCP/mm of cortical thickness; pâ¯<â¯0.01, aging-signature beta(CI)â¯=â¯0.55(0.07-1.03); pâ¯=â¯0.03). Atrophy rates were not significantly different between participants with and without delirium. We found an interaction with delirium severity in the association between atrophy and LTCD (AD-signature beta(CI)â¯=â¯0.04(0.00-0.08), pâ¯=â¯0.04; aging-signature beta(CI)â¯=â¯0.08(0.03-0.12), pâ¯<â¯0.01). The rate of cortical atrophy and severity of delirium are independent, synergistic factors determining postoperative cognitive decline in the elderly.
Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Atrofia
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Imagen por Resonancia Magnética
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Corteza Cerebral
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Delirio
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Enfermedad de Alzheimer
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Disfunción Cognitiva
Límite:
Aged
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Aged80
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Female
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Humans
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Male
Idioma:
En
Revista:
Neurobiol Aging
Año:
2024
Tipo del documento:
Article