The aims of this proposed training grant involve identifying neuroanatomical and neurocognitive predictors of post-operative cognitive dysfunction (POCD) following total knee arthroplasty for individuals age 60 and older. While there have been numerous investigations of POCD following cardiac surgery , very little is known about the effects of non-cardiac operations. Recent studies have identified that POCD is most common among adults age 60+ and following major orthopedic surgery (Monk et al., 2001; Moller et al, 1998). This is alarming, for older adult communities continue to grow in number throughout the country. Relatedly, as life expectancy increases it is projected that """"""""quality of life' surgeries (i.e., total knee arthroplasty) will also increase. If predictors of POCD are identified, the risks associated with these surgeries can be reduced. The present investigation will test the hypothesis that pre-operative neuroanatomical measurements (hippocampus/ entrorhinal volumetrics) will predict the development of POCD. In addition, we seek to identify whether those individuals who perform poorly on pre-operative neurocogntive measures experience greater post-surgical cognitive decline. The development of POCD will be assessed with cognitive measures at two-weeks, three months, and one-year post surgery. We believe that the results of this investigation will assist in predicting post-surgical outcomes thereby reducing the number of adults experiencing possibly irreversible cognitive decline.
