Executive Summary : | The aging population worldwide is expected to grow from 901 million to 1.4 billion between 2015 and 2030, leading to an increase in comorbidities associated with the same age group. This trend has led to a rise in post-operative delirium (POD) and post-operative cognitive dysfunction (POCD) in elderly individuals after surgery. Telomere length (TL) is a heritable trait and biomarker of aging, health, and diseases, and decreased or shortened TL can be predictive of morbidity and mortality. This study aims to observe how TL in peripheral blood leukocytes (PBL) affects the occurrence of common morbidity seen in surgical patients, namely delirium and cognitive dysfunction in the post-operative period. As there are no proven pharmacological strategies to cure cognitive impairments and dementia, this study may help in establishing the role of TL as a predictive biomarker of POD and POCD. The study protocol includes patient admission, clinical history, general physical examination, baseline status of neurocognitive tests, intraoperative management, and intraoperative monitoring. Patients will be placed on a ventilator with a tidal volume of 6-8 ml/kg body weight, with a frequency of respiration set at 12-14 times per minute and PEEP at 5-6 cm of water pressure. Maintenance anesthesia is maintained with a mixture of oxygen, air, and isoflurane, with atracurium administered in the dose of 1/4th of the intubating dose. The study aims to understand the mechanisms of POD and POCD, as well as the potential benefits of various pharmaceutical and non-pharmaceutical interventions to influence the incidence of POCD. |