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Background <p>Postoperative delirium is a significant complication in older adults undergoing cardiac surgery. This study investigated associations between serum amyloid beta (Aβ40, Aβ42), their ratio Aβ42/Aβ40 (AβR), and total tau (tTau) and postoperative delirium.</p> Methods <p>This analysis included participants aged ≥ 60&#xa0;years undergoing elective cardiac surgery with cardiopulmonary bypass. Serum Aβ40, Aβ42 and tTau were measured before surgery and on postoperative day one using a digital immunoassay. The primary outcome was postoperative delirium, assessed twice daily for 3&#xa0;days using the Confusion Assessment Method.</p> Results <p>Postoperative delirium developed in 12% (38/312) of participants. In adjusted analyses examining preoperative biomarkers, the odds of postoperative delirium were independently associated with Aβ40 (OR 1.44 per standard deviation increase, 95% CI 1.06–1.98; <i>p</i> = 0.021), AβR (OR 0.65, 95% CI 0.42–0.99; <i>p</i> = 0.046), and tTau (OR 1.65, 95% CI 1.01–2.68; <i>p</i> = 0.045). Aβ42 was statistically significant only in unadjusted analyses (OR 1.43, 95% CI 1.00–1.88; <i>p</i> = 0.012). In adjusted analyses examining postoperative biomarkers, the odds of postoperative delirium were independently associated with Aβ42 (OR 1.60, 95% CI 1.08–2.37; <i>p</i> = 0.020) and tTau (OR 1.56, 95% CI 1.09–2.23; <i>p</i> = 0.015).</p> Conclusions <p>Aβ40, AβR, and tTau were associated with postoperative delirium in elderly patients undergoing elective cardiac surgery. These findings suggest that postoperative delirium may be linked to pre-existing vulnerabilities shared with neurodegenerative processes along the Alzheimer’s disease spectrum, offering new insights into its underlying mechanisms and potential connection to long-term cognitive decline.</p>

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Associations between Aβ40, Aβ42, and tau and postoperative delirium in older adults undergoing cardiac surgery

  • 期刊论文

  • 发表日期：

    2025年5月12日

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  • Tina B. McKay,
  • Matthew Smith,
  • Ariel Mueller,
  • Haobo Li,
  • Pooja H. Patel,
  • Isaac G. Freedman,
  • Jason Z. Qu,
  • Oluwaseun Akeju

摘要

Background

Postoperative delirium is a significant complication in older adults undergoing cardiac surgery. This study investigated associations between serum amyloid beta (Aβ40, Aβ42), their ratio Aβ42/Aβ40 (AβR), and total tau (tTau) and postoperative delirium.

Methods

This analysis included participants aged ≥ 60 years undergoing elective cardiac surgery with cardiopulmonary bypass. Serum Aβ40, Aβ42 and tTau were measured before surgery and on postoperative day one using a digital immunoassay. The primary outcome was postoperative delirium, assessed twice daily for 3 days using the Confusion Assessment Method.

Results

Postoperative delirium developed in 12% (38/312) of participants. In adjusted analyses examining preoperative biomarkers, the odds of postoperative delirium were independently associated with Aβ40 (OR 1.44 per standard deviation increase, 95% CI 1.06–1.98; p = 0.021), AβR (OR 0.65, 95% CI 0.42–0.99; p = 0.046), and tTau (OR 1.65, 95% CI 1.01–2.68; p = 0.045). Aβ42 was statistically significant only in unadjusted analyses (OR 1.43, 95% CI 1.00–1.88; p = 0.012). In adjusted analyses examining postoperative biomarkers, the odds of postoperative delirium were independently associated with Aβ42 (OR 1.60, 95% CI 1.08–2.37; p = 0.020) and tTau (OR 1.56, 95% CI 1.09–2.23; p = 0.015).

Conclusions

Aβ40, AβR, and tTau were associated with postoperative delirium in elderly patients undergoing elective cardiac surgery. These findings suggest that postoperative delirium may be linked to pre-existing vulnerabilities shared with neurodegenerative processes along the Alzheimer’s disease spectrum, offering new insights into its underlying mechanisms and potential connection to long-term cognitive decline.