The primary outcome of this study is to investigate whether reduced functional correlation of activity between the dorsolateral Pre-Frontal Cortex (dlPFC) and Lateral Parietal regions of interest (seeds of the Executive Control Network) predisposes to postoperative delirium. Secondary outcomes and endpoints (endpoints bulleted below) are to assess the changes from preoperative to postoperative MRI associated with delirium including:
• To assess the perioperative reduction in the anti-correlation (increased connectivity) between the ECN and DMN associated with delirium using fMRI.
• Evidence of ischemic brain damage (FLAIR, SWI, DWI)
• Cerebral Blood Flow (Arterial Spin Labeling)
• White Matter Injury (Diffusion Tensor Imaging)
To identify biomarkers of delirium and neural damage through changes in circulating plasma proteins and molecules (through mass spectrometry)
To determine the influence of clinical and lifestyle features that confer risk and/or resilience to delirium.
To correlate the incidence of delirium with change in cognition from preoperatively to one-year postoperatively.