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2019 Alzheimer's Association Research Fellowship to Promote Diversity (AARF-D)

Postoperative delirium and cognitive outcomes in older adults with and without ADRD: Relationship with baseline characteristics, diversity, and caregiver factors

How might delirium after surgery in older adults impact risk for Alzheimer’s and other dementias?

Franchesca Arias, Ph.D.
Hebrew Rehabilitation Center
Boston, MA - United States


As people age, they are more likely to undergo various surgeries. One common procedure of older age is orthopedic surgeries. Preparation for surgeries especially in older adults, could involve certain health risks including dehydration, delirium (that disrupts mental abilities) among others. But individuals with Alzheimer’s and related dementias may experience more risks, making them more likely to experience postoperative health problems. Scientists, however, have not yet clear as to how dementia or cognitive impairment may impact orthopedic surgery outcomes.

Research Plan

Dr. Franchesca Arias and colleagues will examine links between cognitive impairment and the health risks of orthopedic surgery. For this effort, they will recruit a group of older participants with or without dementia— from an ongoing population study called the Successful Aging after Elective Surgery (SAGES) — who (1) are scheduled for orthopedic surgery and (2) come from a diverse array of ethnic and racial backgrounds. The SAGES study examines the interface between delirium and dementia and whether delirium impacts cognitive impairment and brain changes seen in dementia. Participants will be recruited from medical centers in Massachusetts. Dr. Arias’ team will also recruit the caregivers of the study participants with dementia.
Individuals participating in the study will be monitored before the procedure, and their cognitive and psychological health will be assessed. After the procedure, the participants and caregivers will receive tests to determine their emotional and physical health. This information will be collected over a period of years, post surgery. Dr. Arias’ team will then use this information to determine whether certain kinds of cognitive impairment (such as reduced memory for facts and events or a reduced ability to comprehend language) can impact a person’s ability to prepare for orthopedic surgery
Finally, Dr. Arias and colleagues will conduct interviews with the study participants and their caregivers to investigate their knowledge of surgical procedures and gather their thoughts on the factors that could better facilitate recovery.


Dr. Arias’ project could identify the effects that impaired brain health can have on people undergoing surgery— and how pre-surgery activities may mitigate such effects. These findings may help inform decision-making considerations for individuals with dementia that undergo surgery.

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