Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper

School

Zvart Onanian School of Nursing

Department

Nursing

Date of Original Version

12-31-2021

Abstract

In the older adult surgical population, individuals with dementia are at higher risk for postoperative delirium (POD) which has been associated with a decline in patients’ postoperative function, longer hospital length of stay (LOS), and increased morbidity and mortality (Kassahun, 2018). Although the neuropathology of POD remains not fully understood, the pathology of dementia and Alzheimer’s disease (AD) in particular, has been highly researched. Alterations in dementia-associated biomarkers are seen up to a decade before clinical signs and symptoms are evident resulting in difficulty predicting POD in the older adult population (Olsson et al., 2016). Amyloid-ß 1-42 (Aß42), a dementia-associated biomarker most commonly seen in AD, that aggregates in the brain forming amyloid-ß plaques (Hall & Guyton, 2011). Research on Aß42 suggested that reduced cerebrospinal fluid (CSF) Aß42 concentration reflects the accumulation of Aß42 in the brain and seen before clinical emergence of the disease (Fagan, 2006). The purpose of this systematic review was to determine whether the preoperative CSF concentration of Aß42 in non-dementia older adult surgical patients predicts the incidence of POD. A comprehensive literature review was completed using CINAHL and PubMed/MEDLINE investigating POD and possible relationships with dementia and dementia-associated biomarkers. The PRISMA framework was used to identify eligible studies. Descriptive data tables were completed that reported pertinent data and study outcomes. Individual studies were assessed using the Critical Appraisal Skills Programme (CASP) checklist. A cross-study analysis table was created to compare outcomes across the studies. The findings of this systematic review are inconclusive but suggest that CSF Aß42 may be a potential independent predictor of POD in the older adult surgical population.

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