Katsumi · Brain communications 2022 · prospective cohort study · n=93

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

Level 3 - non-randomized controlled study

Prospective observational cohort study comparing clinical outcomes across defined subgroups

PubMed 35822100 · doi:10.1093/braincomms/fcac163 · record verified 2026-08-26

What was done

In a prospective cohort study drawn from the Successful Aging after Elective Surgery study, 93 cognitively normal older adults undergoing elective surgery were classified as either SuperAgers (n = 19; memory function matching young adults) or typically aging older adults (n = 74). Preoperative structural MRI scans were evaluated for cortical thickness across functional networks. Postoperative delirium incidence and symptom severity were compared between groups and analyzed against anterior mid-cingulate cortex thickness.

What was found

SuperAgers showed lower incidence of postoperative delirium (zero cases) and decreased severity scores compared with typical older adults. Across all 93 patients, greater baseline cortical thickness of the anterior mid-cingulate cortex predicted lower postoperative delirium severity scores. Specific quantitative values for delirium severity and regression effect sizes were not reported in the abstract.

Why it matters

These findings suggest that exceptional baseline memory function and structural integrity of the anterior mid-cingulate cortex confer resilience to postoperative delirium, offering a potential neural biomarker for perioperative risk assessment.

Limits

The study is observational with a small sample size, particularly within the SuperAger subgroup (n = 19). The findings are limited to older adults undergoing elective surgery, and numerical effect estimates, variances, and confidence intervals are not provided in the abstract.