Our healthcare system faces larger numbers of individuals with early to late Alzheimer?s Disease (AD) and other neurodegenerative disorders requiring anesthesia associated procedures for serious health related conditions (e.g., cardiac), screening (e.g., colonoscopy), or quality of life improvement (e.g., joint replacement). Despite evidence that preoperative cognitive status is a risk factor for negative post-operative outcomes, there is a scarcity of research addressing perioperative cognitive-biomarker-anesthesia interactions, and evidence based anesthesia-surgical practices for patients with prodromal or diagnosed dementias. The K07 applicant- an NIH funded independent investigator and board certified neuropsychologist with expertise in the cognitive sequelae and associated neuroimaging markers of AD, vascular dementia, and other neurodegenerative disorders, and cognitive and neuroimaging predictors of perioperative cognitive complications and delirium. The applicant (with support of the institution) is proposing a Perioperative Cognitive Anesthesia Network (PeCAN) Program for AD and related dementia. The purpose? to promote institutional and community awareness of cognition and memory in older adults electing surgical procedures with anesthesia, intensify collaborations on AD biomarkers- anesthesia interactions, and promote translation of research findings to clinical care. The applicant will complete advanced leadership training and three programmatic aims.
Aim 1 - convene a multidisciplinary advisory team to establish four integrated PeCAN research cores targeting AD and related dementia perioperative research. Cores include a Cognitive-Clinical Core, a Neuroimaging Core, a Biomarker Core, and a Data Science Core.
Aim 2 - enhance defined and supportive pathways to the PeCAN cores so that early stage investigators can efficiently initiate and complete perioperative-neurodegenerative research. The applicant will integrate pathways between multiple institutional resources including NIH funded 1Florida Alzheimer?s Disease Research Center, Evelyn F. McKnight Brain Institute, the University of Florida (UF) Institute on Aging Pepper Center, and the UF Fixel Center for Neurological Diseases.
Aim 3 - promote the emergence of highly trained scientists and educators for innovative team science addressing perioperative neuronal risk and mechanisms for protection. Methods will involve implementation of a certificate program, interdisciplinary team-science research opportunities, and pilot funding supported through this grant and institutional matching funds. Trainees will initially include appropriate predoctoral T32 trainees, neuropsychology fellows, and anesthesiology fellows. Milestones- annual analyses of programmatic strengths/weaknesses, multidisciplinary proposal submissions, and evidence of trainee success with perioperative research for AD and related dementias.
Despite expected exponential increases in Alzheimer?s disease (AD) and related dementias, and an overabundance of research indicating that preoperative cognitive impairment is a major risk factor for negative post-operative outcome, we know very little of AD cognitive, biomarker, and anesthesia/surgical interactions and have little to no evidence-based perioperative medical care strategies for AD patients. Via the K07 mechanism and institutional support, the applicant will leverage novel perioperative clinical and state-of-the-art institutional facilities to develop an institutional wide research and training program addressing these problems. The proposed program will result in improved awareness of cognition and memory status in older adults prior to surgical procedures with anesthesia, intensify collaborative research addressing brain-behavior-anesthesia interactions through both animal and human research approaches, and promote translation of research findings to clinical care.
