UVA Health researchers have discovered how a form of postoperative delirium that often strikes older patients “may set the stage for dementia—and identified a drug that could reverse the underlying brain changes,” according to a post by the health system.
The researchers found that “anesthesia, surgery and intensive care stress (ASI) altered gene activity in the brains of aged mice,” producing “disrupted memory formation and regulation of the internal biological clock, leading to cognitive impairment and sleep disturbances similar to those observed in postoperative delirium in human patients.”
They then discovered that when the mice received vorinostat, an FDA-approved drug used to treat certain types of T-cell lymphoma, before anesthesia, surgery and intensive care stress (ASI), many of the changes were reversed, with “improved neuronal structure and cognitive performance,” restoration of “the function of genes involved in memory and regulation of the body’s biological clock, improved sleep patterns, and fewer delirium-like symptoms.”
“Postoperative delirium affects millions of older adults worldwide and is associated with longer hospital stays, increased complications and a greater risk of subsequent cognitive decline. Despite this, the biological mechanisms driving this condition and linking an acute episode of delirium to long-term cognitive decline remain poorly understood,” said Nadia Lunardi, MD, PhD, UVA Health’s neuroanesthesia division chief and a member of the University of Virginia School of Medicine’s Department of Anesthesiology. “By identifying reversible biological changes associated with surgery and intensive care—or perioperative stress—that contribute to postoperative delirium, we hope this work will pave the way for new strategies to prevent the condition and reduce the risk of long-term cognitive decline in vulnerable older patients.”
The study was published in Alzheimer's & Dementia, the journal of the Alzheimer's Association. Read the full study here and read UVA Health’s article about the findings here.
