SAGES II - Successful Aging after Elective Surgery II

Background

Delirium is a clinical syndrome characterized by inattention and disturbance in cognition that develops acutely with a fluctuating course. Delirium is common, serious, and often fatal. It is associated with increased risk of functional decline, nursing home admission, prolonged length of hospital stay, and cognitive decline. It affects up to 60% of hospitalized seniors with costs exceeding $204 billion per year (2021 U.S. dollars).The Successful Aging after Elective Surgery (SAGES) II study was designed to increase knowledge of the pathophysiology and linkages between delirium and dementia. It examines novel biomarkers potentially associated with delirium, including inflammation, Alzheimer's disease (AD) pathology and neurodegeneration, neuroimaging markers, and neurophysiologic markers.

Study Design

The SAGES II study was a 5-year prospective observational study of 420 community dwelling persons, aged 65 years and older, assessed prior to scheduled surgery and  daily throughout hospitalization to observe for development of delirium and other clinical outcomes. Delirium is measured with the Confusion Assessment Method (CAM), long form, after cognitive testing. Cognitive function is measured with a detailed neuropsychologic test battery, summarized as a weighted composite, the General Cognitive Performance (GCP) score. Other key measures include cerebrospinal fluid and plasma-based biomarkers, magnetic resonance imaging (MRI), transcranial magnetic stimulation (TMS)/electroencephalography (EEG), and Amyloid positron emission tomography (PET) imaging.  The imaging/neurophysiology procedures were completed on a subset of participants. 

Conditions

Interventions/Treatment Groups

SAGES II was an observational study; as such, no therapeutic interventions or treatment groups were used in this study.

Results/Conclusions

The study database includes hospital and surgery-related variables, the presence or absence of delirium, delirium severity, clinical outcomes, serial cognitive testing results, and novel biomarkers among participants.