Parkinson’s disease-related non-motor features as risk factors for post-operative delirium in spinal surgery

Ki Hoon Kim, Suk Yun Kang, Dong Ah Shin, Seong Yi, Yoon Ha, Keung Nyun Kim, Young Ho Sohn, Phil Hyu Lee

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background The clinical features of postoperative delirium are similar to the core features of alpha synuclein-related cognitive disorders, such as Parkinson’s disease dementia (PDD) or dementia with Lewy bodies (DLB). Therefore, we hypothesized that the non-motor symptoms (NMSs) in Parkinson’s disease (PD), which precede the cardinal motor features of PD, are likely to be risk factors for developing postoperative delirium. We investigated the association between PD-related NMSs and postoperative delirium in old people undergoing elective spinal surgery. Methods This study was a prospective study. Participants were aged 65 years and older and scheduled to undergo elective spinal surgery. During the enrollment period, 338 individuals were screened, 104 participants were included in the analysis. We assessed eight easily-assessed and representative PD-related NMSs 1 day before the scheduled surgery using tests or questionnaires for each symptom. The presence of delirium was determined by using the short version of the Confusion Assessment Method (CAM). Results Fifteen (14.4%) of the 104 participants (age, 71.7 ± 4.7 years; men, 34.6%) met the CAM criteria for post-operative delirium. Multivariate logistic analysis showed that decreased olfactory function (odds ratio [OR] 0.63, 95% CI 0.44–0.91) and exhibiting rapid eye movement sleep behavior disorder (RBD, OR 1.45, 95% CI 1.09–1.93) were significantly independent predictors of postoperative delirium. Conclusions Our study shows that hyposmia and RBD are significantly independent risk factors for postoperative delirium in general elderly population. Considering that NMSs may represent burden of alpha synuclein deposit, we postulate that an underlying alpha synucleinopathy may correlates with postoperative delirium. Significance This study gives a novel insight for the risk factor of postoperative delirium.

Original languageEnglish
Article numbere0195749
JournalPloS one
Volume13
Issue number4
DOIs
Publication statusPublished - 2018 Apr

Fingerprint

Delirium
Parkinson disease
Surgery
signs and symptoms (animals and humans)
Parkinson Disease
risk factors
surgery
alpha-Synuclein
dementia
odds ratio
Confusion
behavior disorders
Eye movements
logit analysis
sleep
prospective studies
Logistics
Odds Ratio
REM Sleep Behavior Disorder
Deposits

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Kim, Ki Hoon ; Kang, Suk Yun ; Shin, Dong Ah ; Yi, Seong ; Ha, Yoon ; Kim, Keung Nyun ; Sohn, Young Ho ; Lee, Phil Hyu. / Parkinson’s disease-related non-motor features as risk factors for post-operative delirium in spinal surgery. In: PloS one. 2018 ; Vol. 13, No. 4.
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title = "Parkinson’s disease-related non-motor features as risk factors for post-operative delirium in spinal surgery",
abstract = "Background The clinical features of postoperative delirium are similar to the core features of alpha synuclein-related cognitive disorders, such as Parkinson’s disease dementia (PDD) or dementia with Lewy bodies (DLB). Therefore, we hypothesized that the non-motor symptoms (NMSs) in Parkinson’s disease (PD), which precede the cardinal motor features of PD, are likely to be risk factors for developing postoperative delirium. We investigated the association between PD-related NMSs and postoperative delirium in old people undergoing elective spinal surgery. Methods This study was a prospective study. Participants were aged 65 years and older and scheduled to undergo elective spinal surgery. During the enrollment period, 338 individuals were screened, 104 participants were included in the analysis. We assessed eight easily-assessed and representative PD-related NMSs 1 day before the scheduled surgery using tests or questionnaires for each symptom. The presence of delirium was determined by using the short version of the Confusion Assessment Method (CAM). Results Fifteen (14.4{\%}) of the 104 participants (age, 71.7 ± 4.7 years; men, 34.6{\%}) met the CAM criteria for post-operative delirium. Multivariate logistic analysis showed that decreased olfactory function (odds ratio [OR] 0.63, 95{\%} CI 0.44–0.91) and exhibiting rapid eye movement sleep behavior disorder (RBD, OR 1.45, 95{\%} CI 1.09–1.93) were significantly independent predictors of postoperative delirium. Conclusions Our study shows that hyposmia and RBD are significantly independent risk factors for postoperative delirium in general elderly population. Considering that NMSs may represent burden of alpha synuclein deposit, we postulate that an underlying alpha synucleinopathy may correlates with postoperative delirium. Significance This study gives a novel insight for the risk factor of postoperative delirium.",
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language = "English",
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Parkinson’s disease-related non-motor features as risk factors for post-operative delirium in spinal surgery. / Kim, Ki Hoon; Kang, Suk Yun; Shin, Dong Ah; Yi, Seong; Ha, Yoon; Kim, Keung Nyun; Sohn, Young Ho; Lee, Phil Hyu.

In: PloS one, Vol. 13, No. 4, e0195749, 04.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Parkinson’s disease-related non-motor features as risk factors for post-operative delirium in spinal surgery

AU - Kim, Ki Hoon

AU - Kang, Suk Yun

AU - Shin, Dong Ah

AU - Yi, Seong

AU - Ha, Yoon

AU - Kim, Keung Nyun

AU - Sohn, Young Ho

AU - Lee, Phil Hyu

PY - 2018/4

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N2 - Background The clinical features of postoperative delirium are similar to the core features of alpha synuclein-related cognitive disorders, such as Parkinson’s disease dementia (PDD) or dementia with Lewy bodies (DLB). Therefore, we hypothesized that the non-motor symptoms (NMSs) in Parkinson’s disease (PD), which precede the cardinal motor features of PD, are likely to be risk factors for developing postoperative delirium. We investigated the association between PD-related NMSs and postoperative delirium in old people undergoing elective spinal surgery. Methods This study was a prospective study. Participants were aged 65 years and older and scheduled to undergo elective spinal surgery. During the enrollment period, 338 individuals were screened, 104 participants were included in the analysis. We assessed eight easily-assessed and representative PD-related NMSs 1 day before the scheduled surgery using tests or questionnaires for each symptom. The presence of delirium was determined by using the short version of the Confusion Assessment Method (CAM). Results Fifteen (14.4%) of the 104 participants (age, 71.7 ± 4.7 years; men, 34.6%) met the CAM criteria for post-operative delirium. Multivariate logistic analysis showed that decreased olfactory function (odds ratio [OR] 0.63, 95% CI 0.44–0.91) and exhibiting rapid eye movement sleep behavior disorder (RBD, OR 1.45, 95% CI 1.09–1.93) were significantly independent predictors of postoperative delirium. Conclusions Our study shows that hyposmia and RBD are significantly independent risk factors for postoperative delirium in general elderly population. Considering that NMSs may represent burden of alpha synuclein deposit, we postulate that an underlying alpha synucleinopathy may correlates with postoperative delirium. Significance This study gives a novel insight for the risk factor of postoperative delirium.

AB - Background The clinical features of postoperative delirium are similar to the core features of alpha synuclein-related cognitive disorders, such as Parkinson’s disease dementia (PDD) or dementia with Lewy bodies (DLB). Therefore, we hypothesized that the non-motor symptoms (NMSs) in Parkinson’s disease (PD), which precede the cardinal motor features of PD, are likely to be risk factors for developing postoperative delirium. We investigated the association between PD-related NMSs and postoperative delirium in old people undergoing elective spinal surgery. Methods This study was a prospective study. Participants were aged 65 years and older and scheduled to undergo elective spinal surgery. During the enrollment period, 338 individuals were screened, 104 participants were included in the analysis. We assessed eight easily-assessed and representative PD-related NMSs 1 day before the scheduled surgery using tests or questionnaires for each symptom. The presence of delirium was determined by using the short version of the Confusion Assessment Method (CAM). Results Fifteen (14.4%) of the 104 participants (age, 71.7 ± 4.7 years; men, 34.6%) met the CAM criteria for post-operative delirium. Multivariate logistic analysis showed that decreased olfactory function (odds ratio [OR] 0.63, 95% CI 0.44–0.91) and exhibiting rapid eye movement sleep behavior disorder (RBD, OR 1.45, 95% CI 1.09–1.93) were significantly independent predictors of postoperative delirium. Conclusions Our study shows that hyposmia and RBD are significantly independent risk factors for postoperative delirium in general elderly population. Considering that NMSs may represent burden of alpha synuclein deposit, we postulate that an underlying alpha synucleinopathy may correlates with postoperative delirium. Significance This study gives a novel insight for the risk factor of postoperative delirium.

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