Researchers from Southfield-based Beaumont Health and the United Kingdom have been awarded close to $1.7 million by the National Institute on Aging to study the link between dementia and post-operative delirium.
The institute is a division of the U.S. National Institutes of Health. After major surgery, about 17 percent of hospitalized patients ages 65 and older experience delirium – confusion, disorientation, hallucinations, and challenges thinking or remembering.
Post-operative delirium is associated with subsequent cognitive decline and the development of dementia; patients who experience it also have a greater risk of developing Alzheimer’s disease or one of its related dementias.
The condition also can result in longer hospital stays, slower surgical recoveries, an increased need for nursing home care, and a decline in overall health.
“This study is evidence of the benefit of cross disciplinary collaboration for the greater good,” says Stewart Graham, principal investigator, the John and Marilyn Bishop Foundation endowed chair, and the director of Alzheimer’s disease research at the Beaumont Research Institute in Royal Oak. “We are combining expertise from the clinic, bench, and computational biology to help develop objective tests which will enable us to identify those patients who are at greatest risk of developing delirium and subsequent dementia.”
Graham is collaborating with two researchers from Queen’s University Belfast in Ireland – Brian Green and Emma Cunningham, as well as Daniel Davis from University College London.
“We will be able to characterize why these patients develop delirium following elective surgery and potentially be able to develop treatment regimens to help prevent their cognitive decline,” Graham says. “Due to our unique position here at Beaumont Health, and following training from our clinical colleagues in the U.K., we will establish the world’s largest group of patients deemed essential for the successful validation of our initial findings. These are timely and exciting studies deemed vital for understanding delirium and how it relates to cognitive decline.”
Green and Cunningham will further their research into why people who experience post-operative delirium are at an increased risk of developing dementia. They have previously published research in Scientific Reports that showed they found tiny particles called metabolites in cerebrospinal fluid are different in people who develop delirium after surgery compared to people who don’t.
They also found these metabolites were more effective markers of delirium when compared with an Alzheimer’s disease-associated protein, suggesting there is a relationship between people prone to delirium and the later onset of dementia.
“Previously, we have found that arginine-related metabolites, or ‘ARMS,’ are affected both in dementia cases, but also in healthy persons who have displayed delirium following hip or knee surgery,” Green says. “In this research, we are going to look further at this association using patient groups in Northern Ireland and in London to find the underlying reasons why delirium occurs in these individuals. In the United States, our research partners are going to establish a unique prospective group which will be the largest of its kind, enabling us to validate our findings.”
Alzheimer’s disease is a type of dementia affecting a person’s ability to think, communicate, and function. As Americans age, the number of people affected by the disease is rising. According to the Alzheimer’s Association, more than 5 million Americans live with the disease. By 2050, the number is expected to be about 14 million.
Beaumont Health has eight hospitals, 145 outpatient sites, and nearly 5,000 physicians.