Evidence map›Paper›PMID 40355623›Full record

ArticleJournal of neurology2025

Associations between Aβ40, Aβ42, and tau and postoperative delirium in older adults undergoing cardiac surgery.

Tina B McKay, Matthew Smith, Ariel Mueller, Haobo Li, Pooja H Patel, Isaac G Freedman, Jason Z Qu, Oluwaseun Akeju

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Trial
  2. Review
  3. Observational
  4. Review
  5. Observational
  6. Article
  7. Article
  8. Article
  9. Observational
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Tina B McKayDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, EDW 410, Boston, MA, 02114, USA. tmckay@mgh.harvard.edu.
Matthew SmithDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, EDW 410, Boston, MA, 02114, USA.
Ariel MuellerDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, EDW 410, Boston, MA, 02114, USA.
Haobo LiDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, EDW 410, Boston, MA, 02114, USA.
Pooja H PatelDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, EDW 410, Boston, MA, 02114, USA.
Isaac G FreedmanDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, EDW 410, Boston, MA, 02114, USA.
Jason Z QuDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, EDW 410, Boston, MA, 02114, USA.
Oluwaseun AkejuDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, EDW 410, Boston, MA, 02114, USA.

Funding

Minimizing ICU Neurological Dysfunction with Dexmedetomidine-induced Sleep (MINDDS II)R01AG083777 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI JOHNSON-AKEJU, OLUWASEUN · 2024 to 2025
$7.3M
Pathophysiology of postoperative delirium and the use of biomimetic sleep as a treatment strategy in the CSICUR01AG053582 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI JOHNSON-AKEJU, OLUWASEUN · 2016 to 2020
$4.0M
NIA NIH HHS R01 AG053582NIA NIH HHS R01AG053582NIA NIH HHS R01AG083777
6 · The paper itself

Abstract

backgroundPostoperative delirium is a significant complication in older adults undergoing cardiac surgery. This study investigated associations between serum amyloid beta (Aβ40, Aβ42), their ratio Aβ42/Aβ40 (AβR), and total tau (tTau) and postoperative delirium.

methodsThis analysis included participants aged ≥ 60 years undergoing elective cardiac surgery with cardiopulmonary bypass. Serum Aβ40, Aβ42 and tTau were measured before surgery and on postoperative day one using a digital immunoassay. The primary outcome was postoperative delirium, assessed twice daily for 3 days using the Confusion Assessment Method.

resultsPostoperative delirium developed in 12% (38/312) of participants. In adjusted analyses examining preoperative biomarkers, the odds of postoperative delirium were independently associated with Aβ40 (OR 1.44 per standard deviation increase, 95% CI 1.06-1.98; p = 0.021), AβR (OR 0.65, 95% CI 0.42-0.99; p = 0.046), and tTau (OR 1.65, 95% CI 1.01-2.68; p = 0.045). Aβ42 was statistically significant only in unadjusted analyses (OR 1.43, 95% CI 1.00-1.88; p = 0.012). In adjusted analyses examining postoperative biomarkers, the odds of postoperative delirium were independently associated with Aβ42 (OR 1.60, 95% CI 1.08-2.37; p = 0.020) and tTau (OR 1.56, 95% CI 1.09-2.23; p = 0.015).

conclusionsAβ40, AβR, and tTau were associated with postoperative delirium in elderly patients undergoing elective cardiac surgery. These findings suggest that postoperative delirium may be linked to pre-existing vulnerabilities shared with neurodegenerative processes along the Alzheimer's disease spectrum, offering new insights into its underlying mechanisms and potential connection to long-term cognitive decline.

Indexed as

Amyloid beta-PeptidesCardiac Surgical ProceduresDeliriumPeptide FragmentsPostoperative Complicationstau ProteinsAgedAged, 80 and overBiomarkersFemaleHumansMaleMiddle AgedAmyloid beta-Peptidesamyloid beta-protein (1-40)amyloid beta-protein (1-42)BiomarkersMAPT protein, humanPeptide Fragmentstau ProteinsAlzheimer’s disease and related dementiasAmyloid plaquesAmyloid precursor proteinBlood-based biomarkersCognitive dysfunctionNeurodegeneration

Identifiers

PMID40355623
PMCPMC13283758

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.