Highlights From the Successful Aging After Elective Surgery (SAGES) I Study: Fifteen Years of Findings

TL;DR

This paper summarizes key findings from a 15-year study on delirium after surgery in older adults, focusing on its long-term effects and biological markers.

Contribution

The study identifies novel biomarkers and long-term cognitive associations of postoperative delirium in older adults.

Findings

Postoperative delirium is linked to long-term cognitive decline 72 months after surgery.

Phosphorylated-tau 217, a marker of neural injury, is associated with delirium.

Proteomics identified preoperative and postoperative blood biomarkers related to delirium.

Abstract

Delirium, an acute change in cognition, is common, morbid, and costly geriatric syndrome. Although the epidemiology of delirium has been well-characterized, the relationship of delirium with long-term cognitive and functional outcomes remains unclear. Moreover, less is known of the biological underpinnings of postoperative delirium and its associated long-term outcomes. Funded by an NIA program project, the five-year prospective Successful Aging after Elective Surgery (SAGES) I study was launched in 2010 to investigate novel risk factors (e.g., biomarkers, neuroimaging, reserve markers) and to examine the contribution of delirium to long-term cognitive and functional decline. The SAGES I study enrolled 560 adults age ≥70 undergoing major noncardiac surgery who did not have evidence of dementia based on detailed screening process (including a complete baseline neuropsychological test battery and a functional status battery). Fifteen years following enrollment of the first SAGES I participant, this symposium highlights the select key findings of the SAGES I study, including the: 1) relationship between functional recovery following postoperative delirium, 2) association between postoperative delirium and long-term cognitive decline 72 months post-surgery, 3) the association between a novel marker of neural injury, phosphorylated-tau 217, and delirium, and 4) identification of preoperative and postoperative blood biomarkers associated with delirium using a proteomics approach. Taken together, these studies summarize gaps in knowledge that the SAGES study has addressed and paves the way for future promising lines of inquiry in delirium research-expanding our understanding of this geriatric syndrome that threatens the independence and quality of life of older adults.