I am a neurosurgical anesthesiologist with research interests focused on perioperative cognitive dysfunction (POCD) and delirium in geriatric surgical patients. The Beeson Award represents a unique opportunity to attain the skills I will need to become an independent investigator in perioperative geriatric cognition. The research project we have designed for the award period is a prospective cohort study to identify the level of anesthetic depth which may be protective for POCD. For maximal sensitivity we will examine dysfunction in the domains of executive function and memory, and measure the impact of POCD on independent activities of daily living after surgery. This project is based on my pilot data and suggestions from the existing literature that anesthetic depth influences occurrence of POCD, and that POCD in turn influences the occurrence of impairment in activities of daily living. In the short term, this Award period will provide me the opportunity to become an expert in cognition in the elderly, deepen my understanding of monitoring the brain using processed EEG, and learn to quantify function using validated geriatric specific instruments. I will complete coursework in the areas of analysis of cognitive testing, the conduct of clinical research and clinical trials, and epidemiology and prevention methodology in the elderly. My long term goal is create opportunities for anesthesiologists to improve cognitive outcomes for older adults in the perioperative period.
As a result of advances in surgery and anesthesia, millions of elderly patients have major surgical procedures every year. Postoperative cognitive dysfunction (POCD) is a common and persistent complication and is associated with inability to return to preoperative level of function and increased mortality. Anesthesiologists are positioned to improve the health of older Americans by identifying intraoperative opportunities to decrease postoperative POCD.
