2022 Fiscal Year Final Research Report

Improvement of geriatric assessment for older patients received surgery and biomarker discovery

Research Project

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Project/Area Number	17K01841
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Applied health science
Research Institution	Nagoya University
Principal Investigator	TANAKA Chie 名古屋大学, 医学部附属病院, 病院准教授 (50589786)
Co-Investigator(Kenkyū-buntansha)	神田光郎名古屋大学, 医学系研究科, 講師 (00644668) 小寺泰弘名古屋大学, 医学系研究科, 教授 (10345879) 室谷健太久留米大学, 付置研究所, 教授 (10626443) 柳川まどか名古屋大学, 医学部附属病院, 助教 (50566982) 藤原道隆名古屋大学, 医学部附属病院, 病院教授 (70378222)
Project Period (FY)	2017-04-01 – 2023-03-31
Keywords	高齢者機能評価 / 消化器癌手術
Outline of Final Research Achievements	Little knowledge is available for postsurgical changes in cognitive and physical functions that may be useful for considering indication for surgery in elderly patients with gastric cancer. We recruited patients older than 75 years for whom gastrectomy for gastric cancer had been planned, and assessed their cognitive and physical functions, and daily activities before surgery (baseline), upon discharge, and at 6 months after surgery (POM 6). There were no significant decreases in MMSE scores between baseline and at POM 6. As many as 13% of patients were found to have the functional decline on the IADL after surgery. The variable significantly associated with a functional decline in BADL was postoperative complications. To conclude, postoperative cognitive functions did not significantly decline when compared with the baseline scores, although postoperative BADL scores of patients who experienced postoperative complications were significantly lower than those who did not.
Free Research Field	消化器外科学
Academic Significance and Societal Importance of the Research Achievements	これまでに、術前に高齢者機能評価を行い、術後合併症を予測するという報告は散見される。しかし、術前のみでなく術後急性期、急性期から回復した後の高齢者機能を評価した研究はこれまでに見られない。本研究は、各種手術術式により自立度や認知症といった機能がどの程度低下するのかを明らかにしたものであり、患者が治療方針を決定する上で非常に重要な情報となりうると考える。さらに、機能低下に関する術前バイオマーカーを網羅的に探索し、候補タンパクを抽出した。今後、正確な予測ができれば、高齢者の健康寿命の延長のみでなく、地域のケア、介護といった負担を減らすことが可能となる。