UVA Scientists Link Post-Surgery Delirium to Dementia, Suggest Drug Fix

Breakthrough in Understanding Post-Surgery Delirium Offers Hope for Dementia Prevention

Researchers at the University of Virginia have uncovered critical insights into why older patients often experience delirium following surgery, which may progress to dementia. Their study also suggests a promising treatment option.

Dr. Nadia Lunardi, an associate professor of anesthesiology at UVA, and her team have discovered that anesthesia, surgery, and the stress associated with intensive care can adversely affect the cognitive health of elderly mice. Notably, the study indicates that vorinostat, a drug approved by the FDA for cancer treatment, might counteract some of these negative effects.

In an interview with UVA Today, Lunardi shared insights into this groundbreaking research.

Exploring the Impact of Surgery on Cognitive Health

Lunardi described the focus of her research as addressing post-surgery delirium, a condition characterized by a sudden loss of cognitive function in older adults after surgery. Her team is investigating how factors like anesthesia, surgery, sleep disruption, and the stress of hospitalization contribute to this condition.

She explained, “Up until 10 years ago or so, we thought this condition was relatively uncommon and that it would resolve on its own. But there’s been a lot of research since then, and we now realize that this sudden loss of cognition is actually very frequent, particularly as the age of our surgical population continues to grow.” Advances in medical procedures have enabled surgeries on older patients, but the aging brain remains highly susceptible to stressors like anesthesia and surgery, which can trigger changes leading to delirium.

As research progresses, it has become apparent that in some cases, cognitive changes persist long after surgery, sometimes resulting in long-term impairment.

The Role of Vorinostat in Mitigating Delirium Effects

Discussing the potential benefits of vorinostat, Lunardi noted that the drug has shown promise in mitigating cognitive and sleep impairments associated with delirium. “We have demonstrated, both in a mouse model and in tissue from patients who develop delirium after surgery, that a drug already FDA-approved for use in certain types of cancer can improve some of the deficits associated with delirium,” she stated. The next step involves expanding these findings through clinical studies.

Lunardi’s Multifaceted Role at UVA

Beyond her research, Lunardi serves as the chief of the neuroanesthesia division and provides specialized anesthesia for complex brain and spine surgeries at UVA. Leading a team of eight neuroanesthesiologists, she collaborates closely with neurosurgery and orthopedic experts to deliver high-quality patient care.

With a background in critical care and a Ph.D. in pharmacology and toxicology, Lunardi also contributes in the intensive care unit, allowing her to extend care and build relationships with patients and families during challenging times.