Unlocking the Gut Microbiota’s Role in Postoperative Cognitive Decline

Published on February 17, 2023

Imagine your brain is an orchestra, and the gut microbiota are the musicians. This study delves into the importance of these microbial maestros in postoperative cognitive dysfunction (POCD) in elderly patients undergoing orthopedic surgery. By analyzing the gut microbiota and metabolites of 40 enrolled patients, researchers discovered significant differences in the relative abundance of certain bacteria before surgery. Additionally, they identified specific metabolites that impact cognitive function and found that these metabolites play a role in certain metabolic pathways. Although alpha and beta diversity did not differ between POCD and control groups, the relative abundance of 39 ASVs and 20 genera bacterium did show significant differences. Furthermore, the study identified six genera bacterium that could potentially serve as diagnostic indicators for preoperative gut microbiota in elderly POCD patients. This groundbreaking research opens up new possibilities for predicting susceptible populations and targeting interventions to support cognitive health in elderly patients undergoing orthopedic surgery.

ObjectiveTo investigate the role of gut microbiota and metabolites in POCD in elderly orthopedic patients, and screen the preoperative diagnostic indicators of gut microbiota in elderly POCD.Method40 elderly patients undergoing orthopedic surgery were enrolled and divided into Control group and POCD group following neuropsychological assessments. Gut microbiota was determined by 16S rRNA MiSeq sequencing, and metabolomics of GC–MS and LC–MS was used to screen the differential metabolites. We then analyzed the pathways enriched by metabolites.ResultThere was no difference in alpha or beta diversity between Control group and POCD group. There were significant differences in 39 ASV and 20 genera bacterium in the relative abundance. Significant diagnostic efficiency analyzed by the ROC curves were found in 6 genera bacterium. Differential metabolites in the two groups including acetic acid, arachidic acid, pyrophosphate etc. were screened out and enriched to certain metabolic pathways which impacted the cognition function profoundly.ConclusionGut microbiota disorders exist preoperatively in the elderly POCD patients, by which there could be a chance to predict the susceptible population.Clinical Trial Registration[http://www.chictr.org.cn/edit.aspx?pid=133843&htm=4], identifier [ChiCTR2100051162].

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