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Queen’s awarded over $1.67 million to research link between dementia and post-operative delirium

Two researchers from Queen’s have been awarded over $1.67 million in funding by the National Institute on Aging to join a collaborative team of international researchers who will examine the link between dementia and post-operative delirium.

Professor Brian Green from the School of Biological Sciences at Queen’s and coordinator at the Alzheimer’s Research UK (ARUK) Network for Northern Ireland, and Dr Emma Cunningham from the Centre for Public Health at Queen’s, will use this funding from the National Institute on Aging, a division of the U.S. National Institutes of Health, to further explore their research into why people who experience delirium post-operatively are at an increased risk of developing dementia.

The academics will partner with Dr Stewart Graham, who will lead the project at Beaumont Health, Michigan and Dr Daniel Davis from University College London.

Professor Green and Dr Cunningham have previously published research in this area in Scientific Reports. Their research found tiny particles called metabolites in cerebrospinal fluid (CSF) are different in people who develop delirium after surgery compared to people who don’t. They also found that these metabolites were even more effective markers of delirium when combined with an Alzheimer’s disease associated protein, called Aβ42, which suggests there is a relationship between persons prone to delirium and the later onset of dementia.

Professor Green, Leading Researcher from the School of Biological Sciences at Queen’s and coordinator at Alzheimer’s Research UK (ARUK) Network for Northern Ireland, said: “Previously we have found that arginine-related metabolites, or ‘ARMS’, are affected both in dementia cases, but also in healthy persons who have displayed delirium following hip or knee surgery.

“In this research we are going to look further at this association using patient cohorts in Northern Ireland and in London to find the underlying reasons why delirium occurs in these individuals. In the USA our research partners are going to establish a unique prospective cohort which will be the largest of its kind, enabling us to validate our findings.

“Our goal with this research is to develop a full picture of arginine metabolism in cerebrospinal fluid and correlate these results with current biomarkers of Alzheimer’s disease which will help us understand why those prone to delirium are more at risk of dementia in later life.”

Dr Cunningham, Clinical Lecturer in Ageing and Consultant Geriatrician in the Centre for Public Health at Queen’s, said: “Postoperative delirium is a sudden change in attention, awareness or thinking which occurs following surgery. Our investigations have shown that, in Northern Ireland, around one in six people develop delirium following hip and knee replacement surgery.

“We want to better understand how delirium after surgery is related to subsequent dementia. This research will help us better advise people who have delirium after surgery what changes in their memory they should expect over the following years. It will also hopefully pave the way for better treatments for people who get delirium after surgery.”

Dr Stewart Graham, the John and Marilyn Bishop Foundation Endowed Chair and Director of Alzheimer’s Disease Research at Beaumont Health and lead on the project, said: “This study is evidence of the benefit of cross disciplinary collaboration for the greater good. We are combining expertise from the clinic, bench and computational biology to help develop objective tests which will enable us to identify those patients who are at greatest risk of developing delirium and subsequent dementia.

“Furthermore, and importantly, we will be able to characterize why these patients develop delirium following elective surgery and potentially be able to develop prophylactic treatment regimens to help prevent their cognitive decline. Due to our unique position here at Beaumont Health, and following training from our clinical colleagues in the UK, we will establish the world’s largest cohort of patients deemed essential for the successful validation of our initial findings. These are timely and exciting studies deemed vital for understanding delirium and how it relates to cognitive decline.”

Dr Cunningham is also planning related research which is funded by an Alzheimer’s Research UK Clinical Research Fellowship.

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