Cognitive reserve and the risk of postoperative neurocognitive disorders in older age.

Autor:	Borchers F; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany., Rumpel M; Department of Psychology, University of Potsdam, Potsdam, Germany., Laubrock J; Department of Psychology, University of Potsdam, Potsdam, Germany., Spies C; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany., Kozma P; 2nd Department of Internal Medicine and Nephrological Center, University of Pécs Medical School, Pécs, Hungary., Slooter A; Department of Intensive Care Medicine and Brain Center, University Medical Center Utrecht (UMC), Utrecht University, Utrecht, Netherlands., van Montfort SJT; Department of Intensive Care Medicine and Brain Center, University Medical Center Utrecht (UMC), Utrecht University, Utrecht, Netherlands., Piper SK; Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.; Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany., Wiebach J; Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.; Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany., Winterer G; Department of Anesthesiology and Intensive Care Medicine (CCM, CVK), Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.; Pharmaimage Biomarker Solutions Inc., Cambridge, MA, United States.; PI Health Solutions GmbH, Berlin, Germany., Pischon T; Molecular Epidemiology Research Group, Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.; Core Facility Biobank, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.; Biobank Technology Platform, Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany., Feinkohl I; Medical Biometry and Epidemiology Group, Witten/Herdecke University, Witten, Germany.
Jazyk:	angličtina
Zdroj:	Frontiers in aging neuroscience [Front Aging Neurosci] 2024 Feb 05; Vol. 15, pp. 1327388. Date of Electronic Publication: 2024 Feb 05 (Print Publication: 2023).
DOI:	10.3389/fnagi.2023.1327388
Abstrakt:	Background: Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) are postoperative neurocognitive disorders (PNDs) that frequently occur in the aftermath of a surgical intervention. Cognitive reserve (CR) is a concept posited to explain why cognitive health varies between individuals. On this qualitative understanding of cognitive health, factors like IQ, education level, and occupational complexity can affect the impact of neuropathological processes on cognitive outcomes. Methods: We investigated the association between CR and POD and CR and POCD on data from 713 patients aged≥65 years with elective surgery. Peak pre-morbid IQ was estimated from vocabulary. Occupational complexity was coded according to the Dictionary of Occupational Titles (DOT). Education level was classed according to the International Standard Classification of Education (ISCED). These three factors were used as proxies of CR. In a series of regression models, age, sex, depression, site of surgery, and several lifestyle and vascular factors were controlled for. Results: Patients with a higher IQ had lower odds of developing POD. We found no significant association between the other two CR markers with POD. None of the CR markers was associated with POCD. Conclusion: The significant association of a higher IQ with lower POD risk allows for the stratification of elderly surgical patients by risk. This knowledge can aid the prevention and/or early detection of POD. Further research should attempt to determine the lack of associations of CR markers with POCD in our study. Competing Interests: GW is coordinator of the BioCog consortium and is chief executive of the company Pharmaimage Biomarker Solutions GmbH (https://www.pi-pharmaimage.com), and employed by PI Health Solutions GmbH. Among other academic and private partners, the company is a partner of the BioCog study. CS and TP are project leaders in BioCog. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Borchers, Rumpel, Laubrock, Spies, Kozma, Slooter, van Montfort, Piper, Wiebach, Winterer, Pischon and Feinkohl.)
Databáze:	MEDLINE
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