title: Novel risk markers and long-term outcomes of delirium: the successful aging after elective surgery (SAGES) study design and methods.
abstract: OBJECTIVE
  Delirium, a costly, life-threatening, and potentially preventable condition, is a common complication for older adults following major surgery. Although the basic epidemiology of delirium after surgery has been defined, the contribution of delirium to long term outcomes remains uncertain, and novel biomarkers from plasma and neuroimaging have yet to be examined. This program project was designed to contribute to our understanding of the complex multifactorial syndrome of delirium.
  
  
  METHODS
  Long term prospective cohort study.
  
  
  METHODS
  Three academic medical centers (2 hospitals and 1 coordinating center).
  
  
  METHODS
  Patients without recognized dementia (targeted cohort= 550 patients) age 70 and older scheduled to undergo elective major surgery are assessed at baseline before surgery, daily during their hospital stay, and for 18 to 36 months after discharge.
  
  
  METHODS
  The Successful Aging after Elective Surgery (SAGES) study is an innovative, interdisciplinary study that includes biomarkers, neuroimaging, cognitive reserve markers, and serial neuropsychological testing to examine the contribution of delirium to long term cognitive and functional decline. The primary goal is to examine the contribution of delirium to long term cognitive and functional decline. In addition, novel risk markers for delirium are being examined, including plasma biomarkers (eg, cytokines, proteomics), advanced neuroimaging markers (eg, volumetric, white matter hyperintensity, noncontrast blood flow, and diffusion tensor measures), and cognitive reserve markers (eg, education, occupation, lifetime activities).
  
  
  CONCLUSIONS
  Results from this study will contribute to a fuller understanding of the etiology and prognosis of delirium. Ultimately, we hope this project will provide the groundwork for future development of prevention and treatment strategies for delirium, designed to minimize the long term negative impact of delirium in older adults.
authors.affiliation: Aging Brain Center, Institute for Aging Research, Boston, MA 02131, USA.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Schmitt
authors.forename: Edward R
authors.initials: ER
authors.lastname: Marcantonio
authors.forename: David C
authors.initials: DC
authors.lastname: Alsop
authors.forename: Richard N
authors.initials: RN
authors.lastname: Jones
authors.forename: Selwyn O
authors.initials: SO
authors.lastname: Rogers
authors.forename: Tamara G
authors.initials: TG
authors.lastname: Fong
authors.forename: Eran
authors.initials: E
authors.lastname: Metzger
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Inouye
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D000375:Aging; D015415:Biomarkers / Q000097:blood*; D001900:Boston; D016208:Databases, Factual; D003693:Delirium / Q000209:etiology*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D011183:Postoperative Complications; D011446:Prospective Studies; D036301:Qualitative Research; D012107:Research Design; D018570:Risk Assessment / Q000379:methods
chemical_list: D015415:Biomarkers