Researcher Beaumont leads an international team studying the link between post-operative delirium and the subsequent onset of dementia

Newswise – After major surgery, approximately 17% of hospitalized patients aged 65 and over experience delirium: confusion, disorientation, hallucinations, along with difficulty thinking or remembering. In 2018, 374,873 adults underwent total hip surgery and 650,674 underwent knee replacement surgeries in the U.S. Approximately 170,000 of these patients may have had postoperative delirium, which is associated with subsequent cognitive decline and development. of dementia. These patients are also at an increased risk of developing Alzheimer’s disease or one of its related dementias.

A collaborative team of researchers from the UK and the Beaumont Research Institute in Royal Oak, Michigan, has received more than $ 1.67 million from the National Institute on Aging, a division of the US National Institutes of Health, to study the link between dementia and post-operative delirium.

Post-operative delirium can result in longer hospital stays, slower surgical recoveries, an increased need for home care, and a decline in overall health.

Alzheimer’s disease is a type of dementia that affects a person’s ability to think, communicate and function. It has a big impact on their relationships, their independence and their lifestyle. As Americans age, the number of people with Alzheimer’s is dramatically increasing. According to the Alzheimer’s Association, more than 5 million Americans are living with Alzheimer’s. By 2050, the number is estimated to be around 14 million. The disease toll not only affects millions of people, but Alzheimer’s and other dementias will cost the nation $ 305 billion in 2020.

Lead investigator Stewart Graham, Ph.D., president of the John and Marilyn Bishop Foundation Endowed Chair and director of Alzheimer’s Disease Research at the Beaumont Research Institute, said, “This study is evidence of the benefit of interdisciplinary collaboration for superior good. We are combining clinical, bench and computational biology expertise to help develop objective tests that will allow us to identify those patients who are at increased risk of developing delirium and subsequent dementia. “

Dr Graham will collaborate and collaborate with two researchers from Queen’s University Belfast in Northern Ireland: Professor Brian Green and Dr Emma Cunningham; together with Dr. Daniel Davis of University College London.

“Most importantly, we will be able to characterize why these patients develop delirium after elective surgery and potentially be able to develop treatment regimens to help prevent their cognitive decline,” added Dr. Graham. “Thanks to our unique position here at Beaumont Health, and following the training of our clinical colleagues in the UK, we will create the largest patient group in the world deemed essential to the successful validation of our initial results. These are timely and exciting studies deemed vital to understanding delusion and how it relates to cognitive decline. “

Green of the School of Biological Sciences at Queen’s and coordinator at the Alzheimer’s Research UK Network for Northern Ireland, and Dr Emma Cunningham of the Center for Public Health at Queen’s, will use NIA funding to further explore their research on the because people who experience post-operative delirium are at an increased risk of developing dementia.

Green and Dr. Cunningham have previously published research in Scientific Reports. Their research found that tiny particles called metabolites in the cerebrospinal fluid are different in people who develop delirium after surgery than in people who don’t. They also found that these metabolites were even more effective markers of delirium when combined with an Alzheimer’s disease-associated protein called Aβ42, which suggests that there is a relationship between people prone to delirium and the subsequent onset of dementia.

Green explained: “We have previously found that arginine-related metabolites, or ‘ARMS’, are affected both in cases of dementia, but also in healthy people who have experienced delirium after hip or knee surgery. In this research, we will further investigate this association using patient groups in Northern Ireland and London to find the reasons behind the delirium in these individuals. In the United States, our research partners will create a potential unique group that will be the largest of its kind, allowing us to validate our findings.

“Our goal with this research is to develop a comprehensive picture of arginine metabolism in the cerebrospinal fluid and correlate these findings with current Alzheimer’s disease biomarkers that will help us understand why those prone to delirium are more at risk for dementia. in old age “.

Dr Cunningham, Clinical Aging Lecturer and Geriatrician Consultant said, “Postoperative delirium is a sudden change in attention, awareness or thinking that occurs after surgery. Our surveys have shown that around one in six people in Northern Ireland develop delirium following hip and knee replacement surgery.

“We want to better understand how delirium after surgery is related to subsequent dementia. This research will help us better advise people suffering from delirium after surgery what changes in their memory they should expect in the following years. It is also hoped that it will pave the way for better treatments for people suffering from delirium after surgery. “

Dr Cunningham is planning related research which is funded by an Alzheimer’s Research UK Clinical Research Fellowship.

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