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2019 Alzheimer's Association Clinical Scientist Fellowship to Promote Diversity (AACSF-D)

AD Pathology and Perioperative Neurocognitive Disorders

Can measuring the presence of certain biomarkers and brain changes before surgery, help predict whether an individual may be at a higher risk of experiencing impaired memory after surgery?  

Mary Ackenbom, M.D.
University of Pittsburgh
Pittsburgh, PA - United States


Some older individuals may experience temporary cognitive impairment (such as memory disturbances) after undergoing surgery (called post-operative neurocognitive decline, PNCD). These impairments can last anywhere between days to years. Scientists are unclear whether PNCD may increase an individual’s risk of developing dementia late or if these individuals have preexisting brain changes (which may occur prior to the development of dementia) and if that could increase their vulnerability to surgery.
The beta-amyloid protein accumulates to form plaques in the brain, a hallmark brain change of Alzheimer’s. These plaques are associated with other brain changes including disruption of nerve cell communication and increased activation of immune cells, triggering inflammation. Dr. Mary Ackenbom and colleagues will determine whether older individuals with high beta-amyloid levels in the brain and signs of inflammation  as measured by blood before surgery are more likely to develop PNCD after surgery.

Research Plan

Dr. Ackenbom’s team will conduct a study with 30 women, 70 years of age or older, who are scheduled to undergo urogynecologic surgery (surgical procedures to treat pelvic floor disorders). For each participant, the researchers will use brain scans to measure the levels of beta-amyloid in the brain before surgery and again at 2 weeks, 3 months, and 1 year after surgery.
The researchers will also measure proteins in the blood as biological markers (biomarkers) that could indicate inflammation and test the study participants’ cognitive function (such as memory, thinking etc.) before and after surgery. Dr. Ackenbom and her team will then analyze the scans, blood samples, and cognitive measures to determine whether there are patterns in individuals that when present before surgery, could increase their risk for developing PNCD post-surgery.


This study may help determine whether certain changes in the brain and blood-based biomarkers associated with Alzheimer’s can be used to identify older people who are more likely to develop cognitive decline after surgery. If successful, these results could be used to study a larger population of older adults before and after surgery and to possibly identify individuals that would benefit from interventions to mediate this risk.

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