ISTAART-AAGP Collaborative symposium: Perioperative cognition and neuropsychiatric symptoms

Abstract

Professional Interest Areas (PIA) are an assembly of Alzheimer's association ISTAART (International Society to Alzheimer's research and treatment) members with common interests. We present the work of two professional interest areas, perioperative cognition and delirium PIA and neuropsychiatric syndrome PIA which we believe will be most interest to AAGP learners and audience as it shares common subject matter.There is considerable clinical evidence that the process of anesthesia and surgery independently causes cognitive decline, known as Perioperative Neurocognitive Disorders (PND) (previously known as Postoperative Cognitive Dysfunction (POCD)). This includes postoperative delirium and postoperative neurocognitive disorder (postoperative NCD). We know that patients with even subtle impairment preoperatively are at increased risk of these disorders. There is also a large body of laboratory evidence demonstrating an association between anesthetic agents and Alzheimer's disease neuropathology. In this session we will discuss history and nomenclature of perioperative neurocognitive disorder and discuss the challenges in providing perioperative cognitive screening within a preoperative anesthesia center.We will also discuss neuropsychiatric syndrome and its association with cognition and neuroimaging measures of amyloid, tau and neurodegeneration. Neuropsychiatric symptoms are being increasing recognized as often being the first clinical symptom of cognitive impairment and thus important for understanding prognosis and directing new treatment paradigms.NPS present prior to any cognitive decline (mild cognitive impairment/Alzheimer's disease) and this led to a concept of Mild behavioral impairment led by Zahinoor Ismail's work which we will discuss in this session. Finally, we will also discuss that some of the neuropsychiatric symptoms are associated with changes in tau and hippocampal volume.