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Are the impairments of arginine metabolism as found in Alzheimer's disease also present in patients developing post-operative delirium and cognitive decline?

Award Number: R33AG067083
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Are the impairments of arginine metabolism as found in Alzheimer's disease also present in patients developing post-operative delirium and cognitive decline? - Abstract: Older people require specific care when undergoing an operation, principally because events around surgery and anesthesia can precipitate delirium. The prevalence of postoperative delirium depends on type of surgery, but an overall postoperative incidence of 17% is a reasonable estimate. The pathophysiological mechanisms that underpin postoperative delirium and its sequelae have yet to be systematically studied. Certain pathways may account for the development of delirium itself, while others may drive longer-term cognitive outcomes such as progression of dementia. The degree to which these interrelate, are separate or shared is completely unknown. One approach to investigate the neural basis of delirium has been to use CSF samples obtained through regional anesthesia. We propose investigating the neural basis of delirium by using CSF samples obtained in the course of spinal anesthesia, combining biomarkers with clinical and demographic information. Our preliminary data indicates arginine metabolism may be a predictor of delirium in CSF. In this study we aim to extend on our previous work, and accurately quantify all arginine related metabolites and complement this data set with protein expression levels for this metabolic cascade. Our goal is to develop a comprehensive picture of arginine metabolism in CSF and correlate these results with current pathophysiological biomarkers of Alzheimer’s disease. Further, having extended our biochemical coverage of arginine metabolism, we will develop novel biomarkers capable of predicting those patients at greatest risk of developing delirium and subsequent cognitive decline. Having defined the biochemical signature of delirium, it will be important to determine which patients later developed dementia and/or significant neurodegeneration following surgery. Therefore, we will complete a long term follow up of our original patients to determine who developed Alzheimer’s disease or one of its related dementias and correlate those findings with our results. Moreover, and to ensure the validity of our delirium biomarker panel, we will prospectively recruit participants undergoing planned joint replacement surgery at Beaumont Health (>4,000 at Beaumont Royal Oak, 2018), perform pre-operative clinical and cognitive assessments and postoperative delirium screening. Having access to such a large and diverse patient population will provide the us with an optimal, independent validation set. In summary, our overarching goals for this proposal are to: (i) develop an existing collaboration with the largest CSF-delirium repository to date (n=358) in order to extend on current findings; (ii) develop new biomarker panels; (iii) perform a long term follow up of our initial cohort and (iv) validate our findings in a large and diverse US based population.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $302,065 )
2024	2024	WILLIAM BEAUMONT HOSPITAL	26901 BEAUMONT BLVD # 6D	SOUTHFIELD	MI	48033	OAKLAND	USA	Aging Research	001	3	5/21/2024	NON-COMPETING CONTINUATION	$302,065
2024	2023	WILLIAM BEAUMONT HOSPITAL	3601 W 13 MILE RD	ROYAL OAK	MI	48073	OAKLAND	USA	Aging Research	000	2	10/13/2023	EXTENSION WITH OR WITHOUT FUNDS	$0
														Subtotal = $302,065

Issue Date FY: 2023 ( Subtotal = $200,774 )
2023	2023	WILLIAM BEAUMONT HOSPITAL	3601 W 13 MILE RD	ROYAL OAK	MI	48073	OAKLAND	USA	Aging Research	000	2	8/15/2023	EXTENSION WITH OR WITHOUT FUNDS	$200,774
2023	2023	WILLIAM BEAUMONT HOSPITAL	3601 W 13 MILE RD	ROYAL OAK	MI	48073	OAKLAND	USA	Aging Research	001	2	9/12/2023	EXTENSION WITH OR WITHOUT FUNDS	$0
														Subtotal = $200,774

Grand Total All Awards = $502,839

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Are the impairments of arginine metabolism as found in Alzheimer's disease also present in patients developing post-operative delirium and cognitive decline?

Award Number: R33AG067083

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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