PREDICTORS OF POCD IN OLDER ADULTS

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 这是312-2002号议定书的一个子研究。这项建议的主要目标是确定神经解剖学和神经认知预测60岁及以上人群全膝关节置换术后认知功能障碍(POCD)的指标。虽然心脏手术后POCD的研究很多，但对非心脏手术的影响知之甚少。最近的研究发现POCD在60岁以上的成人和大型整形外科手术后最为常见(Monk等人，2001；Moller等人，198)。这是令人震惊的，因为全国老年人社区的数量继续增加。与此相关的是，随着预期寿命的增加，预计生活质量？手术(即全膝关节置换术)也将增加。如果确定了POCD的预测因素，与这些手术相关的风险可以降低。本研究验证了一种假说，即术前神经解剖学测量(海马体/内鼻孔皮质)将预测POCD的发展。此外，我们试图确定那些在术前神经认知测量中表现不佳的人是否会经历更大的手术后认知能力下降。还将评估体积测量、神经认知测量和生化标记物之间的关系。术后两周、三个月和一年后将用认知测量来评估POCD的发展。参与者将与骨科合作获得。他们的手术将在佛罗里达大学斯汉兹医院或北佛罗里达-南乔治亚州退伍军人S管理部门进行。核磁共振检查将在麦克奈特脑研究所进行。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This is a sub-study of protocol 312-2002. The primary objectives of this proposal are to identify neuroanatomical and neurocognitive predictors of post-operative cognitive dysfunction (POCD) following total knee arthroplasty for individuals 60 and older. While there have been numerous investigations of POCD following cardiac surgery, very little is known about the effects of non-cardiac operations. Recent studies have identified that POCD is most common among adults age 60+ and following major orthopedic surgery (Monk et al., 2001; Moller et al., 198). This is alarming, for older adult communities continue to grow in number throughout the country. Related, as life expectancy increases, it is projected that ?quality of life? surgeries (i.e., total knee arthroplasty) will also increase. If predictors of POCD are identified, the risks associated with these surgeries can be reduced. The present investigation tests the hypothesis that pre-operative neuroanatomical measurements (hippocampus/ entrorhinal cortex) will predict the development of POCD. In addition, we seek to identify whether those individuals who perform poorly on pre-operative neurocognitive measures experiences greater post-surgical cognitive decline. Relationships between the volumetrics, neurocognitive measures, and biochemical markers will also be assessed. The development of POCD will be assessed with cognitive measures at two-weeks, three months, and one-year post surgery. Participants will be obtained in collaboration with the Department of Orthopedics. Their surgery will be performed at Shands Hospital at the University of Florida or the North Florida-South Georgia Veteran?s Administration. The MRI procedures will be performed at the McKnight Brain Institute.