Postoperative Cognitive Dysfunction in Elderly and it's Relation With Sleep Disorders and Melanin Concentrating Hormone

February 6, 2026 updated by: Mohamed Yasein Mohamed Moawad, Minia University

Postoperative Delayed Neurocognitive Recovery in Elderly Patients Undergoing Spinal Anesthesia: Assessment of Its Prevalence and Correlation With Preoperative Sleep Disorders and Melanin Concentrating Hormone.

The aim of this study is to explore the relationship between preoperative sleep disorders, melanin-concentrating hormone (MCH), and delayed neurocognitive recovery early after surgery in older adult patients undergoing spinal anesthesia.

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

Perioperative neurocognitive disorders (PNDs) have gradually become a priority during the perioperative period, including neurocognitive disorder before surgery, delirium and delayed neurocognitive recovery (DNR) within 30 days after surgery, and postoperative neurocognitive disorder up to 12 months after surgery. The incidence of DNR ranges from 9.1% to 45%, which seriously affects the perioperative brain health of older adult patients .

The increasing aging population and the reduced function and compensatory capacity of various systems in elderly patients also significantly increase the risk of cognitive dysfunction .

Sleep disorders are critical risk factors among the various risk factors for DNR after surgery. Meanwhile, aging is an independent risk factor for sleep disorders .

Therefore, it is clinically significant to conduct early cognitive risk prediction, focusing on older adult patients with preoperative sleep disorders. Studies have explored the risk factors for perioperative sleep disorders, while other studies have also explored the risk factors affecting postoperative cognitive outcomes. However, no study has explored the specific risk factors for DNR in patients with preoperative sleep disorders. Considering the relationship between sleep and postoperative cognitive function, especially in older adult patients, it is necessary to link these 2 main risk factors (preoperative sleep disorders and DNR) that impair the perioperative brain health to explore potential biomarkers .

Melanin-concentrating hormone (MCH) is a highly conserved cyclic neuropeptide with 19 amino acids in mammals and has a variety of physiological functions, including orexigenic properties, energy homeostasis, regulation of moods, sleep, wakefulness, and cognitive functions .

Melanin-concentrating hormone (MCH) can enhance synaptic plasticity in the hippocampus, which plays an important role in maintaining cognitive function In addition to regulating synaptic plasticity, MCH can also regulate cognitive functions such as learning and memory by regulating rapid eye movement (REM) sleep and acetylcholine outflow in the hippocampus .

Study Type

Observational

Enrollment (Estimated)

50

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Mohamed Yasein Mohamed, Assistant lecturer
  • Phone Number: +20 01016383701
  • Email: myasein76@yahoo.com

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

A total of (50) patients candidate for elective lower limb surgery aged from 65 years of both sexes will be enrolled in this study.

Description

Inclusion Criteria:

  • Patients of both genders ageing 65 years or above.
  • ASA grade I to III.
  • Undergo elective lower limb surgery under spinal anesthesia
  • Agree to collect one's own CSF and blood samples

Exclusion Criteria:

  • Past history of depression,anxiety,delirium and schizophrenia .
  • Past history of drug dependence.
  • Past history of dementia,including Alzheimer disease(AD).
  • Preoperative Montreal Cognitive Assessment (MoCA) score <26.
  • Inability to understand or cooperate with the evaluation scale or questionnaire.
  • Refuse collecting one's own CSF and blood samples.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Group A
25 patients with preoperative sleep disorders
Group B
25 patients without preoperative sleep disorders

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
To investigate the impact of preoperative sleep problems as indicators of delayed neurocognitive recovery (DNR) in elderly adults following spinal anesthesia.
Time Frame: Baseline, one week, three months
By comparison between the two groups
Baseline, one week, three months

Secondary Outcome Measures

Outcome Measure
Time Frame
to investigate the predictive power of CSF and plasma MCH levels for delayed neurocognitive recovery (DNR) in older adults after spinal anesthesia
Time Frame: Baseline one day before operation
Baseline one day before operation

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Minia University

Investigators

  • Principal Investigator: Mohamed Mostafa Ali, MD, El-minya University Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • Wagner S, Ahrens E, Wachtendorf LJ, et al. Association of obstructive sleep apnea with postoperative delirium in procedures of moderate-to-high complexity: a hospital-registry study. Anesth Analg. 2023.
  • Travica N, Lotfaliany M, Marriott A, et al. Peri-operative risk factors associated with post-operative cognitive dysfunction (POCD): an umbrella review of meta-analyses of observational studies. J Clin Med. 2023;12:1610.
  • POIRIER, Gabriel, et al. Deterioration, compensation and motor control processes in healthy aging, mild cognitive impairment and Alzheimer's disease. Geriatrics, 2021, 6.1: 33
  • Monti JM, Torterolo P, Lagos P. Melanin-concentrating hormone control of sleep-wake behavior. Sleep Med Rev.2013;17:293-298. Nasreddine ZS, Phillips NA, Bedirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695-699.
  • Li Yun,Zhang Xizhe, et al . Research progress on the role of melanin-concentrating hormone system in sleep deprivation -induced impairment of learning and memory function [ J ] . International Journal of Anesthesiology and Resuscitation , 2022 , 43 ( 10 ): 1117-1120 .
  • Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res.1989;28:193-213.
  • Butris N, Tang E, Pivetta B, et al. The prevalence and risk factors of sleep disturbances in surgical patients:a systematic review and meta-analysis. Sleep Med Rev.2023;69:101786.
  • Nasreddine ZS, Phillips NA, Bedirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695-699.
  • Monti JM, Torterolo P, Lagos P. Melanin-concentrating hormone control of sleep-wake behavior. Sleep Med Rev.2013;17:293-298.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

February 1, 2026

Primary Completion (Estimated)

February 1, 2027

Study Completion (Estimated)

April 1, 2027

Study Registration Dates

First Submitted

January 31, 2026

First Submitted That Met QC Criteria

January 31, 2026

First Posted (Actual)

February 6, 2026

Study Record Updates

Last Update Posted (Actual)

February 10, 2026

Last Update Submitted That Met QC Criteria

February 6, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Postop. cognitive dysfunction

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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