Postoperative delirium is associated with grey matter brain volume loss
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Postoperative delirium is associated with grey matter brain volume loss. / Kant, Ilse M J; de Bresser, Jeroen; van Montfort, Simone J T; Witkamp, Theodoor D; Walraad, Bob; Spies, Claudia D; Hendrikse, Jeroen; van Dellen, Edwin; Slooter, Arjen J C; BioCog Consortium.
In: BRAIN COMMUN, Vol. 5, No. 1, 2023, p. fcad013.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Postoperative delirium is associated with grey matter brain volume loss
AU - Kant, Ilse M J
AU - de Bresser, Jeroen
AU - van Montfort, Simone J T
AU - Witkamp, Theodoor D
AU - Walraad, Bob
AU - Spies, Claudia D
AU - Hendrikse, Jeroen
AU - van Dellen, Edwin
AU - Slooter, Arjen J C
AU - BioCog Consortium
N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of the Guarantors of Brain.
PY - 2023
Y1 - 2023
N2 - Delirium is associated with long-term cognitive dysfunction and with increased brain atrophy. However, it is unclear whether these problems result from or predisposes to delirium. We aimed to investigate preoperative to postoperative brain changes, as well as the role of delirium in these changes over time. We investigated the effects of surgery and postoperative delirium with brain MRIs made before and 3 months after major elective surgery in 299 elderly patients, and an MRI with a 3 months follow-up MRI in 48 non-surgical control participants. To study the effects of surgery and delirium, we compared brain volumes, white matter hyperintensities and brain infarcts between baseline and follow-up MRIs, using multiple regression analyses adjusting for possible confounders. Within the patients group, 37 persons (12%) developed postoperative delirium. Surgical patients showed a greater decrease in grey matter volume than non-surgical control participants [linear regression: B (95% confidence interval) = -0.65% of intracranial volume (-1.01 to -0.29, P < 0.005)]. Within the surgery group, delirium was associated with a greater decrease in grey matter volume [B (95% confidence interval): -0.44% of intracranial volume (-0.82 to -0.06, P = 0.02)]. Furthermore, within the patients, delirium was associated with a non-significantly increased risk of a new postoperative brain infarct [logistic regression: odds ratio (95% confidence interval): 2.8 (0.7-11.1), P = 0.14]. Our study was the first to investigate the association between delirium and preoperative to postoperative brain volume changes, suggesting that delirium is associated with increased progression of grey matter volume loss.
AB - Delirium is associated with long-term cognitive dysfunction and with increased brain atrophy. However, it is unclear whether these problems result from or predisposes to delirium. We aimed to investigate preoperative to postoperative brain changes, as well as the role of delirium in these changes over time. We investigated the effects of surgery and postoperative delirium with brain MRIs made before and 3 months after major elective surgery in 299 elderly patients, and an MRI with a 3 months follow-up MRI in 48 non-surgical control participants. To study the effects of surgery and delirium, we compared brain volumes, white matter hyperintensities and brain infarcts between baseline and follow-up MRIs, using multiple regression analyses adjusting for possible confounders. Within the patients group, 37 persons (12%) developed postoperative delirium. Surgical patients showed a greater decrease in grey matter volume than non-surgical control participants [linear regression: B (95% confidence interval) = -0.65% of intracranial volume (-1.01 to -0.29, P < 0.005)]. Within the surgery group, delirium was associated with a greater decrease in grey matter volume [B (95% confidence interval): -0.44% of intracranial volume (-0.82 to -0.06, P = 0.02)]. Furthermore, within the patients, delirium was associated with a non-significantly increased risk of a new postoperative brain infarct [logistic regression: odds ratio (95% confidence interval): 2.8 (0.7-11.1), P = 0.14]. Our study was the first to investigate the association between delirium and preoperative to postoperative brain volume changes, suggesting that delirium is associated with increased progression of grey matter volume loss.
U2 - 10.1093/braincomms/fcad013
DO - 10.1093/braincomms/fcad013
M3 - SCORING: Journal article
C2 - 36819940
VL - 5
SP - fcad013
JO - BRAIN COMMUN
JF - BRAIN COMMUN
SN - 2632-1297
IS - 1
ER -
