Successful aging after elective surgery II: Study cohort description

Author:

Ward Michelle1,Hshieh Tammy T.234,Schmitt Eva M.2,Arnold Steven E.45,Cavallari Michele26,Dickerson Bradford C.45,Dillon Simon T.7,Fong Tamara G.248,Jones Richard N.9,Libermann Towia A.47,Pascual‐Leone Alvaro21011,Shafi Mouhsin M.48,Touroutoglou Alexandra45,Weng Karen2,Xu Guoquan2,Earp Brandon E.412,Kunze Lisa413,Lange Jeffrey414,Vlassakov Kamen415,Marcantonio Edward R.1416,Inouye Sharon K.247,Travison Thomas G.247,

Affiliation:

1. Division of General Medicine, Department of Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USA

2. Hinda and Arthur Marcus Institute for Aging Research Hebrew SeniorLife Boston Massachusetts USA

3. Division of Aging, Department of Medicine Brigham and Women's Hospital Boston Massachusetts USA

4. Harvard Medical School Boston Massachusetts USA

5. Department of Neurology Massachusetts General Hospital Boston Massachusetts USA

6. Center for Neurological Imaging, Department of Radiology Brigham and Women's Hospital Boston Massachusetts USA

7. Department of Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USA

8. Berenson‐Allen Center for Noninvasive Brain Stimulation, Department of Neurology Beth Israel Deaconess Medical Center Boston Massachusetts USA

9. Department of Psychiatry and Human Behavior, Department of Neurology, Warren Alpert Medical School Brown University Providence Rhode Island USA

10. Deanna and Sidney Wolk Center for Memory Health HebrewSeniorLife Boston Massachusetts USA

11. Department of Neurology Harvard Medical School Boston Massachusetts USA

12. Department of Orthopedic Surgery Brigham and Women's Faulkner Hospital Boston Massachusetts USA

13. Department of Anesthesia, Critical Care and Pain Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USA

14. Department of Orthopedic Surgery Brigham and Women's Hospital Boston Massachusetts USA

15. Department of Anesthesiology, Perioperative and Pain Medicine Brigham and Women's Hospital Boston Massachusetts USA

16. Division of Gerontology, Department of Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USA

Abstract

AbstractBackgroundThe Successful Aging after Elective Surgery (SAGES) II Study was designed to examine the relationship between delirium and Alzheimer's disease and related dementias (AD/ADRD), by capturing novel fluid biomarkers, neuroimaging markers, and neurophysiological measurements. The goal of this paper is to provide the first complete description of the enrolled cohort, which details the baseline characteristics and data completion. We also describe the study modifications necessitated by the COVID‐19 pandemic, and lay the foundation for future work using this cohort.MethodsSAGES II is a prospective observational cohort study of community‐dwelling adults age 65 and older undergoing major non‐cardiac surgery. Participants were assessed preoperatively, throughout hospitalization, and at 1, 2, 6, 12, and 18 months following discharge to assess cognitive and physical functioning. Since participants were enrolled throughout the COVID‐19 pandemic, procedural modifications were designed to reduce missing data and allow for high data quality.ResultsAbout 420 participants were enrolled with a mean (standard deviation) age of 73.4 (5.6) years, including 14% minority participants. Eighty‐eight percent of participants had either total knee or hip replacements; the most common surgery was total knee replacement with 210 participants (50%). Despite the challenges posed by the COVID‐19 pandemic, which required the use of novel procedures such as video assessments, there were minimal missing interviews during hospitalization and up to 1‐month follow‐up; nearly 90% of enrolled participants completed interviews through 6‐month follow‐up.ConclusionWhile there are many longitudinal studies of older adults, this study is unique in measuring health outcomes following surgery, along with risk factors for delirium through the application of novel biomarkers—including fluid (plasma and cerebrospinal fluid), imaging, and electrophysiological markers. This paper is the first to describe the characteristics of this unique cohort and the data collected, enabling future work using this novel and important resource.

Funder

Harvard Medical School

National Institute on Aging

Publisher

Wiley

Subject

Geriatrics and Gerontology

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