Esketamine tied to less decline after surgery at 60–80 with sleep loss
Among sleep-deprived patients, cognitive decline seven days after surgery occurred in 32.5% without esketamine and 17.7% with it.
Paper by Xiaomin Zhang, Li Yuan, Yanlin Chen et al.
Limit: Cognitive decline was assessed only seven days after surgery
Edited by Boris Djordjevic · AgingResearch.News
A retrospective observational cohort study included 398 adults aged 60–80 who underwent planned major surgery other than heart surgery. Researchers grouped patients by exposure to the drug esketamine around surgery and sleep deprivation the night before. Sleep deprivation meant less than four hours asleep and spending less than 70% of time in bed asleep. They assessed cognitive decline seven days after surgery using tests of mental abilities.
After accounting for measured patient differences, esketamine exposure was associated with lower odds of decline in sleep-deprived patients. Blood analyses in a subgroup linked sleep deprivation to signs of oxidative stress—an imbalance that can damage cells—and inflammation. These abnormalities were less pronounced in patients exposed to esketamine.
Why it matters
Sleep loss may increase older adults’ vulnerability to cognitive problems after surgery. The study addresses whether inflammation and cell-damage processes are linked to that vulnerability.
Caveats
This retrospective observational study cannot establish that esketamine caused the difference, and blood biomarkers do not establish a mechanism in the brain. The findings concern adults aged 60–80 undergoing planned major non-cardiac surgery.
The paper
Xiaomin Zhang, Li Yuan, Yanlin Chen et al.
Frontiers in Cell and Developmental Biology, Oct 30, 2026, CC BY, Accepted, not yet published
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