Picture this: the operating room is a stage, the patient center stage. As the curtains rise, a delicate pas de deux begins between mild cognitive impairment (MCI) and postoperative delirium (POD). The lead dancers? Anesthesia and surgical procedures. This study took a closer look at their performance during total knee arthroplasty, exploring the relationship between MCI and POD. Using criteria for diagnosing MCI and assessing POD, this research revealed that MCI increased the risk for developing POD. But what’s behind this dance? The brain’s core pathology of POD, revealed through cerebrospinal fluid biomarkers. Amyloid pathology and tau protein took center stage, mediating the impact of MCI on cognition. This discovery suggests that MCI might be an important factor to consider in predicting POD outcomes. So, if you’re curious about this captivating medical ballet, pirouette your way to the link below to dive into the full research and become a backstage witness to the fascinating interplay of MCI and POD!
BackgroundPatients undergoing surgery are at a higher risk of developing postoperative delirium (POD) as a result of anesthesia and surgical procedures. This study examined the association between POD and mild cognitive impairment (MCI) and whether MCI influences POD through the core pathology of POD.MethodsWe enrolled Chinese Han patients undergoing unilateral total knee arthroplasty (aged 50–90, weighing 50–80 kg, and using ASAI-II), combined with epidural anesthesia between October 2020 and June 2021. All the participants were assessed using Winblad’s criteria for diagnosing MCI on pre-operation and using the Confusion Assessment Method (CAM) and the Memorial Delirium Assessment Scale (MDAS) postoperative 1–7 days (or before discharge) for diagnosing POD by an anesthesiologist. Cerebrospinal fluid (CSF) biomarkers of POD were measured by enzyme-linked immunosorbent assay (ELISA). To examine the mechanism by which POD pathologies affect cognition, causal mediation analyses were performed.ResultsPOD incidence was 20.2%, including 32.5% in the MCI group and 12.4% in the non-mild cognitive impairment (NMCI) group. The MCI and CSF levels of T-tau and P-tau were risk factors, and the CSF levels of Aβ42, Aβ42/ T-tau, and Aβ42/ P-tau were protective factors in POD (p < 0.05). Part of the effects of MCI on cognition can be attributed to amyloid pathology and tau.ConclusionMCI may be a reasonably good prognostic factor in POD development. Overall, amyloid pathology and tau protein might partially mediate the influence of MCI on POD.Clinical trial registrationwww.clinicaltrials.gov, identifier: ChiCTR2000033439.
Dr. David Lowemann, M.Sc, Ph.D., is a co-founder of the Institute for the Future of Human Potential, where he leads the charge in pioneering Self-Enhancement Science for the Success of Society. With a keen interest in exploring the untapped potential of the human mind, Dr. Lowemann has dedicated his career to pushing the boundaries of human capabilities and understanding.
Armed with a Master of Science degree and a Ph.D. in his field, Dr. Lowemann has consistently been at the forefront of research and innovation, delving into ways to optimize human performance, cognition, and overall well-being. His work at the Institute revolves around a profound commitment to harnessing cutting-edge science and technology to help individuals lead more fulfilling and intelligent lives.
Dr. Lowemann’s influence extends to the educational platform BetterSmarter.me, where he shares his insights, findings, and personal development strategies with a broader audience. His ongoing mission is shaping the way we perceive and leverage the vast capacities of the human mind, offering invaluable contributions to society’s overall success and collective well-being.