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2017 Grants - Schenning
Sex and Genetic Risk Factors in Postoperative Dementia
Katie Schenning, M.D., M.P.H.
Oregon Health and Science University
2017 Alzheimer’s Association Clinician Scientist Fellowship (AACSF)
How does a person’s sex and genetic background contribute to cognitive decline after surgery?
Cognitive decline is a common complication for older adults who have undergone surgery or been treated with anesthesia. Although not everyone is affected, recent studies have shown adults over the age of 65 have an increased risk of cognitive dysfunction, dementia, and Alzheimer’s disease after an operation. Older surgery patients are also more likely to have brain changes associated with Alzheimer’s. These include increases in beta-amyloid plaques and tau tangles inside brain cells.
Scientists are not entirely sure what makes one person experience these postoperative side effects while others remain unaffected. Understanding genetic or sex-specific risk factors could help doctors identify and provide the safest care for patients before, during, and after surgery. Tailored care may also help prevent postoperative cognitive decline in at-risk patients.
Katie Schenning, M.D., M.P.H. and colleagues will study older male and female surgery patients to determine differences between patients who develop postoperative cognitive decline, and those who do not. The researchers will focus on differences in genes known to underlie Alzheimer’s, including APOE-e4 and PLA2. Dr. Schenning and colleagues will study if sex-specific differences are confirmed by these genes that led to postoperative cognitive impairment.
The team expects to identify specific genetic variables that increase a person’s risk for postoperative cognitive decline. The most at-risk patients could be recruited for future clinical trials designed to prevent surgery or anesthesia side effects related to Alzheimer’s.
This study may help scientists better understand the mechanisms behind postoperative cognitive decline, so that it could be minimized in the future. Also, this study may help doctors more accurately explain risks and benefits to older patients as they consider surgical procedures.