Does Apolipoprotein E Genotype Increase Risk of Postoperative Delirium?
Sarinnapha Vasunilashorn1, Long Ngo1, Cyrus M Kosar2
1Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Summary
The apolipoprotein E (ApoE) genotype does not influence the risk, severity, or duration of postoperative delirium in older patients without dementia. This study found no association between ApoE and delirium outcomes.
Area of Science:
- Geriatric Medicine
- Neuroscience
- Genetics
Background:
- Postoperative delirium is a common complication in older adults, significantly impacting recovery and long-term outcomes.
- The apolipoprotein E (ApoE) genotype, a known risk factor for Alzheimer's disease, has been investigated for its potential role in cognitive complications following surgery.
Purpose of the Study:
- To investigate the association between apolipoprotein E (ApoE) genotype and the incidence, severity, and duration of postoperative delirium.
- To determine if ApoE ε2 or ε4 alleles confer risk or protection against delirium in elderly surgical patients.
Main Methods:
- A cohort of 557 non-demented patients aged 70+ undergoing major noncardiac surgery was analyzed.
- Apolipoprotein E (ApoE) genotypes (ε2, ε4 carriers vs. noncarriers) and delirium incidence/severity (using Confusion Assessment Method) were assessed.
- Generalized linear models were used to evaluate the association between ApoE and delirium outcomes, adjusting for covariates.
Main Results:
- Postoperative delirium occurred in 24% of patients; ApoE ε4 and ε2 alleles were present in 19% and 15% of the cohort, respectively.
- No statistically significant association was found between ApoE ε4 or ε2 carrier status and the incidence of postoperative delirium (RR ε4=1.0; RR ε2=0.9).
- Apolipoprotein E (ApoE) genotype was not associated with delirium severity (peak CAM-S score) or the number of delirium days.
Conclusions:
- The findings do not support the hypothesis that ApoE genotype influences postoperative delirium risk, severity, or duration in older, non-demented surgical patients.
- This suggests that a key genetic risk factor for Alzheimer's disease does not play a role in the development of postoperative delirium.
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