DIVULGE-2 – Predicting Delirium Vulnerability in Older Surgical Patients

DelIrium VULnerability in GEriatrics (DIVULGE-2): Predicting Delirium Vulnerability from Pre-Surgery Neurophysiological Measures.

Delirium is common among hospitalised older adults, with a 2020 meta-analysis of 33 studies reporting an overall prevalence of 23%. Systematic reviews examining cardiac procedures have reported delirium rates of approximately 24% following coronary artery bypass grafting, and between 7.2% and 21.4% following transcatheter aortic valve replacement, depending on the technique used. Delirium has been identified as a strong risk factor for death, with one study reporting a 39% mortality rate, and is linked to a threefold increase in incident dementia among older adults. Delirium is increasingly understood to be a disorder of disrupted network integration.

DIVULGE-2 will identify if patterns of neural activity differ between older adults who develop delirium post-surgery compared to those who do not. In addition, it will determine the patterns of neural activity that differentiate between the development of delirium subtypes. A pilot study has already suggested that distinct patterns of brain activity are associated with the development of postoperative delirium and its subtypes. This study will aim to recruit 350 participants across South Australia. It is funded by the National Health and Medical Research Council (NHMRC).