Structural integrity of the anterior mid‐cingulate cortex contributes to resilience to delirium in SuperAging

Background Identifying factors that confer resilience to developing delirium is critical given the negative impact of on clinical care and risk for mortality. Here, we investigated a cohort cognitively normal older adults undergoing elective surgery examined role pre-operative memory function cortical thickness in incidence severity post-operative (POD). We hypothesized 1) those with episodic comparable young (“SuperAgers" or SA) would show reduced POD compared typically-aging (TOA) 2) anterior mid-cingulate cortex (aMCC), integrity which has been consistently associated SuperAging, predict POD. Method 19 SA 74 TOA (mean age 75.8 +/- 4.1; 57F/36M) completed neuropsychological testing underwent structural brain MRI pre-operatively as part Successful AGing after Elective Surgery (SAGES) Study. were identified based criteria defined previous studies. Delirium assessed using Confusion Assessment (CAM) daily throughout hospitalization. A general linear model analysis was performed identify regions cerebral whose CAM scores. Results No differences found education between TOA. Remarkably, no developed POD; occurred only group (D-TOA = 15). Severity negatively bilateral aMCC. one-way ANOVA comparing mean aMCC across subgroups revealed significant effect (F(2,89) 3.09, p ≤ .05), greatest D-TOA (t(31) 2.47, .019, Cohen’s d 0.89), but seen non-delirious (ND) (t(76) 0.72, .72, 0.10). Greater also observed ND-TOAs D-TOAs (t(71) 2.26, .03 0.72). Conclusion These findings suggest superior greater may be important indices can serve target preventive therapeutic interventions.