Association of Depressive Symptoms With Postoperative Delirium and CSF Biomarkers for Alzheimer's Disease Among Hip Fracture Patients.
Alzheimer's disease
amyloid
csf
delirium
depression
hip fracture
mild behavioral impairment
tau
Journal
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
ISSN: 1545-7214
Titre abrégé: Am J Geriatr Psychiatry
Pays: England
ID NLM: 9309609
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
16
12
2020
revised:
29
01
2021
accepted:
01
02
2021
pubmed:
1
3
2021
medline:
30
11
2021
entrez:
28
2
2021
Statut:
ppublish
Résumé
While there is growing evidence of an association between depressive symptoms and postoperative delirium, the underlying pathophysiological mechanisms remain unknown. The goal of this study was to explore the association between depression and postoperative delirium in hip fracture patients, and to examine Alzheimer's disease (AD) pathology as a potential underlying mechanism linking depressive symptoms and delirium. Patients 65 years old or older (N = 199) who were undergoing hip fracture repair and enrolled in the study "A Strategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients" completed the 15-item Geriatric Depression Scale (GDS-15) preoperatively. Cerebrospinal fluid (CSF) was obtained during spinal anesthesia and assayed for amyloid-beta (Aβ) 40, 42, total tau (t-tau), and phosphorylated tau (p-tau) For every one point increase in GDS-15, there was a 13% increase in odds of postoperative delirium, adjusted for baseline cognition (MMSE), age, sex, race, education and CSF AD biomarkers (OR = 1.13, 95%CI = 1.02-1.25). Both CSF Aβ42/t-tau (β = -1.52, 95%CI = -2.1 to -0.05) and Aβ42/p-tau In older adults undergoing hip fracture repair, depressive symptoms were associated with underlying AD pathology and postoperative delirium. Mild baseline depressive symptoms were the strongest predictor of postoperative delirium, and may represent a dementia prodrome.
Identifiants
pubmed: 33640268
pii: S1064-7481(21)00166-4
doi: 10.1016/j.jagp.2021.02.001
pmc: PMC8815817
mid: NIHMS1670080
pii:
doi:
Substances chimiques
Amyloid beta-Peptides
0
Biomarkers
0
Peptide Fragments
0
tau Proteins
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1212-1221Subventions
Organisme : NIA NIH HHS
ID : R01 AG051658
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG066507
Pays : United States
Organisme : NIA NIH HHS
ID : K24 AG035075
Pays : United States
Organisme : NIA NIH HHS
ID : K23 AG043504
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG033615
Pays : United States
Organisme : NIA NIH HHS
ID : R24 AG054259
Pays : United States
Organisme : NIA NIH HHS
ID : P01 AG031720
Pays : United States
Organisme : NCRR NIH HHS
ID : KL2 RR025006
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG057725
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR003098
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001079
Pays : United States
Organisme : NIA NIH HHS
ID : P50 AG005146
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2021 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
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