Author:
Liu Chen,Ding Ke,Abdul Mannan,Sun Qing-Chun,Zhang Zhen-Feng,Dong Meng-Meng,Han Liu,Dai Ming-Sheng,Guan Hui-Lian,Han Yuan,Liu He,Chen Xue-Fen,Cao Jun-Li
Abstract
Abstract
Background
Cognitive decline following surgery is a common concern among elderly individuals. Leukocyte telomere length (LTL) can be assessed as a biological clock connected to an individual lifespan. However, the mechanisms causing this inference are still not fully understood. As a result of this, LTL has the potential to be useful as an aging-related biomarker for assessing delayed neurocognitive recovery (dNCR) and related diseases.
Methods
For this study, 196 individuals over 60 who were scheduled due to major non-cardiac surgical operations attended neuropsychological testing before surgery, followed by additional testing one week later. The finding of dNCR was based on a measured Z-score ≤ -1.96 on two or more separate tests. The frequency of dNCR was presented as the primary outcome of the study. Secondly, we evaluated the association between dNCR and preoperative LTL.
Results
Overall, 20.4% [40/196; 95% confidence interval (CI), 14.7–26.1%] of patients exhibited dNCR 1-week post-surgery. Longer LTL was identified as a predictor for the onset of early cognitive impairment resulting in postoperative cognitive decline [odds ratio (OR), 14.82; 95% CI, 4.01–54.84; P < 0.001], following adjustment of age (OR, 12.33; 95% CI, 3.29–46.24; P < 0.001). The dNCR incidence based on LTL values of these patients, the area under the receiver operating characteristic (ROC) curve was 0.79 (95% CI, 0.722–0.859; P < 0.001). At an optimal cut-off value of 0.959, LTL values offered respective specificity and sensitivity values of 64.7% and 87.5%.
Conclusions
In summary, the current study revealed that the incidence of dNCR was strongly associated with prolonged LTL. Furthermore, this biomarker could help identify high-risk patients and offer insight into the pathophysiology of dNCR.
Funder
the Natural Science Foundation of Shanghai
Shenkang Clinical Study Foundation of Shanghai
Zhejiang Provincial Natural Science Foundation
National Natural Science Foundation of China
the Discipline Construction Project of School of Public Health in Shanghai University of Traditional Chinese Medicine
the National Key R&D Program of China
Jiangsu Provincial Special Program of Medical Science
Basic and Clinical Research Center in Anesthesiology of Jiangsu Provincial "Science and Education for Health" Project
Publisher
Springer Science and Business Media LLC
Subject
Anesthesiology and Pain Medicine