A prospective pilot study on plasma amyloid beta oligomers and postoperative delirium

초록

Introduction Postoperative delirium (POD) is common in older adults and has been linked to Alzheimer's disease (AD). Plasma amyloid-beta oligomers (A beta Os) may clarify this relationship. We evaluated whether preoperative A beta O burden is associated with POD severity.Methods In this single-center prospective pilot study, we enrolled 22 patients aged >= 65 years undergoing hip or knee arthroplasty under general anesthesia. Blood was drawn preoperatively and postoperatively to quantify oligomerized amyloid-beta using the multimer detection system (MDS-Oa beta). POD was assessed with the Korean version of the Delirium Rating Scale-98 (K-DRS-98). Group comparisons and correlations examined associations between MDS-Oa beta and POD.Results Eleven of 22 patients developed POD. Those with POD were older and had higher preoperative MDS-Oa beta than those without POD (0.81 vs 0.56 ng/mL). There was no significant perioperative change in MDS-Oa beta, suggesting surgery or anesthesia did not alter the plasma A beta oligomerization tendency. Within the POD group, preoperative MDS-Oa beta correlated with both K-DRS-98 severity and total scores.Discussion In this pilot cohort, higher preoperative A beta O burden was associated with the occurrence and severity of POD, while perioperative factors did not measurably affect A beta O levels. These findings support a potential mechanistic link between AD-related pathology and POD. Given the small sample (N=22), estimates are imprecise and hypothesis-generating; validation in larger, multicenter studies is required before clinical application.

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