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A Mouse Model of Orthopedic Surgery to Study Postoperative Cognitive Dysfunction and Tissue Regeneration
Published on: February 27, 2018
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Sex and genetic differences in postoperative cognitive dysfunction: a longitudinal cohort analysis.
Katie J Schenning1, Charles F Murchison2, Nora C Mattek3,4,5
1Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Mail Code L459, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA. malcore@ohsu.edu.
Biology of Sex Differences
|March 30, 2019
Summary
Older men carrying the Apolipoprotein E-ε4 (APOE4) allele may face a higher risk of postoperative cognitive dysfunction (POCD) after surgery and anesthesia compared to women. Further research is needed to understand these sex-based differences in POCD vulnerability.
Area of Science:
- Gerontology
- Neuroscience
- Anesthesiology
Background:
- Postoperative cognitive dysfunction (POCD) is a common complication in older adults (65+), representing over a third of US surgical patients.
- The specific biological risk factors, including genetics and sex, predisposing individuals to POCD remain unclear.
- Alzheimer's disease risk factors may influence POCD susceptibility in the elderly population.
Purpose of the Study:
- To investigate if biological sex and Apolipoprotein E-ε4 (APOE4) carrier status increase the risk of developing POCD in older adults.
- To determine the differential impact of APOE4 on cognitive outcomes in men and women post-surgery.
Main Methods:
- A cohort analysis of 1033 participants from longitudinal aging studies was conducted.
- Participants underwent regular cognitive testing, with annual changes analyzed.
- Mixed-effects models assessed the relationship between sex, APOE4 status, surgery, anesthesia, and cognitive decline.
Main Results:
- No significant sex differences in overall postoperative cognitive outcomes were observed between men and women who underwent surgery.
- However, men with the APOE4 allele demonstrated significantly poorer cognitive performance after surgery and anesthesia compared to women APOE4 carriers.
- These findings persisted even after adjusting for age, education, and comorbidities.
Conclusions:
- Older men carrying the APOE4 allele may be more susceptible to postoperative cognitive dysfunction than older women with the same genetic marker.
- The APOE4 genotype may interact with biological sex to influence cognitive vulnerability following surgical procedures.
- These results highlight potential sex-specific biological risk factors for POCD.
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