Cognitive and Cerebrospinal Fluid Alzheimer’s Disease–related Biomarker Trajectories in Older Surgical Patients and Matched Nonsurgical Controls
Authors' conclusion
During a 1-yr time period, as compared to matched nonsurgical controls, the study found no evidence that older patients who underwent anesthesia and noncardiac, nonneurologic surgery had accelerated CSF Alzheimer's disease-related biomarker (tau, p-tau, and Aβ) changes or greater cognitive decline.
Study context
- Population
- Adults 60 yr or older undergoing major nonneurologic surgery and matched nonsurgical controls
- Participants
- 140 vs 51
- Exposure
- Major nonneurologic surgery vs nonsurgical controls
- Surgicaln = 140
- Nonsurgical controlsn = 51reference
- Outcome
- CSF Aβ, tau, p-tau levels and tau/Aβ, p-tau/Aβ ratios
- Follow-up
- 24 hr, 6 weeks and 1 yr
Methodological detailsstrata-based matching on age, sex, and years of education, Groups well matched on 25 of 31 baseline characteristics
- Strata-based matching on age, sex, and years of education
- Groups well matched on 25 of 31 baseline characteristics
Main finding
As reported in the abstract
- No effect of group or group-by-time interaction for baseline to 24-hr or 6-week postoperative changes in cerebrospinal fluid (CSF) Aβ, tau, p-tau or tau/Aβ, p-tau/Aβ ratios
- Bonferroni P > 0.05 for all
- No difference between groups in these CSF markers at 1 yr
- P > 0.05 for all
Observational data: associations, not effects.
Further findings
| Outcome | Mean difference (95% CI) | P value | |
|---|---|---|---|
| Baseline cognition | 0.19 (−0.06 to 0.43) | P = 0.132 | |
| −0.200.20.40.6Difference (linear scale) |
| Outcome | β (95% CI) | P value |
|---|---|---|
| Cognitive change · 1 yr | −0.31 (−0.45 to −0.17) | P < 0.001 |
- Cognitive change: greater decline in controls, controlling for baseline differences
Cognitive change · 1 yr
- No difference between groups in 1-yr cognitive change in models using imputation or inverse probability weighting for loss to follow up
Original publication
Cognitive and Cerebrospinal Fluid Alzheimer’s Disease–related Biomarker Trajectories in Older Surgical Patients and Matched Nonsurgical Controls. Anesthesiology. Published 7 February 2024. doi:10.
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