Studies Assess Postoperative Cognitive Impairment
Older individuals are at risk of prolonged cognitive problems after surgery
MONDAY, Jan. 7 (HealthDay News) -- Postoperative cognitive impairment is common in adults of all ages, but only elderly patients are at risk of prolonged cognitive problems, and the type and severity of cognitive impairment varies based on time after surgery, according to two articles published in the January issue of Anesthesiology.
Terri G. Monk, M.D., of Duke University in Durham, N.C., and colleagues conducted neuropsychological testing on 1,064 adult patients prior to, at hospital discharge, and three months after they underwent major non-cardiac surgery, and found that cognitive impairment at hospital discharge was common in adult patients, but only older individuals (age 60 and older) had an increased risk of prolonged cognitive problems. In addition, one-year mortality was greater in patients with postoperative cognitive dysfunction.
In a second study, Catherine C. Price, Ph.D., of the University of Florida in Gainesville, and colleagues assessed cognitive function and instrumental activities of daily living in 60 controls and 337 older non-cardiac surgical patients at baseline, at hospital discharge, and/or three months after surgery. Over half of the patients experienced cognitive decline at hospital discharge, whereas at three months 75 percent of patients had no cognitive decline, 13.6 percent showed only memory decline, 8.4 percent showed only executive function decline, and 2.9 percent had deficits in both executive function and memory.
"At three months post-surgery, more older adults experienced memory decline, but only those with executive or combined [memory and executive] cognitive decline had functional limitations," Price and colleagues write. "Future research should examine how perioperative factors influence neuronal systems."