Postoperative neurocognitive disorders (PND), which include postoperative delirium and both acute and longlasting neurocognitive deficits, are a significant public health problem, leading to a cascade of deleterious complications. Older adults are particularly at-risk of developing PND both in the short and long term. Although age is consistently reported as an important risk factor, the exact pathophysiology of PND remains poorly understood, but may include postsurgery-compromised blood brain barrier (BBB) function. This project proposes that perioperative BBB dysfunction is associated with measurable brain morphologic findings in cognitive control areas that can be discovered with non-invasive magnetic resonance imaging (MRI). Patients scheduled for surgery with an age range of 65-75 years of age, will participate in brain diffusion-weighted pseudo-continuous arterial spin labeling (DW-pCASL) and diffusion tensor imaging (DTI), cognitive assessments, and evaluation of a BBB marker from blood (at baseline, at two weeks, and at six months after surgery). All patients will have a brain scan (MRI) within before surgery and two weeks and six months after surgery. During this visit cognitive function will be assessed. Patients will also be asked to participate in a blood draw.
Age range
65 Years – 75 Years
Sex
ALL
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Preoperative cognitive function
Timeframe: pre-surgery (within five days before)
Postoperative cognitive dysfunction - delayed cognitive recovery
Timeframe: Post-surgery (within two weeks post surgery)
Postoperative cognitive dysfunction - neurocognitive disorder
Timeframe: Post-surgery (6 months after surgery)
Preoperative cognitive function II
Timeframe: Pre-surgery (within five days before surgery)
Postoperative cognitive dysfunction - delayed cognitive recovery II
Timeframe: Post-surgery (within two weeks post surgery)
Postoperative cognitive dysfunction - neurocognitive disorder II
Timeframe: Post-surgery (6 months after surgery)