Relationship between 18-flutemetamol Amyloid imaging and post surgery delirium in elderly.

Aims. The primary aims of this case-control study will be (i) to estimate the association of [18F]-flutemetamol positivity in patients with delirium after surgery for hip fracture (ii) to study the predictive power of PET with [18F]-flutemetamol as a predictive marker of cognitive deterioration after delirium. Forty cases with delirium and 40 controls with no delirium after surgery for hip fracture will be recruited and studied in two Italian Orthopedic Wards.

Methods. A trained personal will assess possible development of delirium by the Confusion Assessment Method to each patient enrolled in the study, daily for 3 days after surgery. Within 30 days after surgery a physician and a psychologist will carry out a baseline clinical, cognitive and functional assessment. Moreover, patients will undergo 18F-flutemetamol PET scan and magnetic resonance imaging with structural, diffusion, and T2* BOLD functional sequences, and EEG to study structural and functional markers of neurodegeneration.

Impact of the study. [18F]-flutemetamol positivity might be the first biological marker of delirium in the elderly and could be used in the routine assessment of patients undergoing surgical procedures.