TY - JOUR
T1 - Novel Risk Markers and Long-Term Outcomes of Delirium
T2 - The Successful Aging after Elective Surgery (SAGES) Study Design and Methods
AU - Schmitt, Eva M.
AU - Marcantonio, Edward R.
AU - Alsop, David C.
AU - Jones, Richard N.
AU - Rogers, Selwyn O.
AU - Fong, Tamara G.
AU - Metzger, Eran
AU - Inouye, Sharon K.
PY - 2012/11
Y1 - 2012/11
N2 - Objectives: Delirium, a costly, life-threatening, and potentially preventable condition, is a common complication for older adults following major surgery. Although the basic epidemiology of delirium after surgery has been defined, the contribution of delirium to long term outcomes remains uncertain, and novel biomarkers from plasma and neuroimaging have yet to be examined. This program project was designed to contribute to our understanding of the complex multifactorial syndrome of delirium. Design: Long term prospective cohort study. Setting: Three academic medical centers (2 hospitals and 1 coordinating center). Participants: Patients without recognized dementia (targeted cohort = 550 patients) age 70 and older scheduled to undergo elective major surgery are assessed at baseline before surgery, daily during their hospital stay, and for 18 to 36 months after discharge. Measurements: The Successful Aging after Elective Surgery (SAGES) study is an innovative, interdisciplinary study that includes biomarkers, neuroimaging, cognitive reserve markers, and serial neuropsychological testing to examine the contribution of delirium to long term cognitive and functional decline. The primary goal is to examine the contribution of delirium to long term cognitive and functional decline. In addition, novel risk markers for delirium are being examined, including plasma biomarkers (eg, cytokines, proteomics), advanced neuroimaging markers (eg, volumetric, white matter hyperintensity, noncontrast blood flow, and diffusion tensor measures), and cognitive reserve markers (eg, education, occupation, lifetime activities). Conclusion: Results from this study will contribute to a fuller understanding of the etiology and prognosis of delirium. Ultimately, we hope this project will provide the groundwork for future development of prevention and treatment strategies for delirium, designed to minimize the long term negative impact of delirium in older adults.
AB - Objectives: Delirium, a costly, life-threatening, and potentially preventable condition, is a common complication for older adults following major surgery. Although the basic epidemiology of delirium after surgery has been defined, the contribution of delirium to long term outcomes remains uncertain, and novel biomarkers from plasma and neuroimaging have yet to be examined. This program project was designed to contribute to our understanding of the complex multifactorial syndrome of delirium. Design: Long term prospective cohort study. Setting: Three academic medical centers (2 hospitals and 1 coordinating center). Participants: Patients without recognized dementia (targeted cohort = 550 patients) age 70 and older scheduled to undergo elective major surgery are assessed at baseline before surgery, daily during their hospital stay, and for 18 to 36 months after discharge. Measurements: The Successful Aging after Elective Surgery (SAGES) study is an innovative, interdisciplinary study that includes biomarkers, neuroimaging, cognitive reserve markers, and serial neuropsychological testing to examine the contribution of delirium to long term cognitive and functional decline. The primary goal is to examine the contribution of delirium to long term cognitive and functional decline. In addition, novel risk markers for delirium are being examined, including plasma biomarkers (eg, cytokines, proteomics), advanced neuroimaging markers (eg, volumetric, white matter hyperintensity, noncontrast blood flow, and diffusion tensor measures), and cognitive reserve markers (eg, education, occupation, lifetime activities). Conclusion: Results from this study will contribute to a fuller understanding of the etiology and prognosis of delirium. Ultimately, we hope this project will provide the groundwork for future development of prevention and treatment strategies for delirium, designed to minimize the long term negative impact of delirium in older adults.
KW - Delirium
KW - Dementia
KW - Elderly
KW - Long term outcomes
KW - Risk factors
KW - Surgery
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UR - http://www.scopus.com/inward/citedby.url?scp=84868350963&partnerID=8YFLogxK
U2 - 10.1016/j.jamda.2012.08.004
DO - 10.1016/j.jamda.2012.08.004
M3 - Article
C2 - 22999782
AN - SCOPUS:84868350963
SN - 1525-8610
VL - 13
SP - 818.e1-818.e10
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 9
ER -