Risk of Developing Cognitive Problems High Among Elderly Surgical Patients

Researchers at the Duke University Medical Center have revealed that patients over the age of 60, who have elective surgeries such as joint replacements, hysterectomies and other non-emergency, inpatient procedures, are at an increased risk for long-term cognitive problems.

During the study, the researchers also found that elderly patients who developed these postoperative cognitive problems were more likely to die in the first year after surgery.

“We have known that patients undergoing heart surgery are at risk for cognitive dysfunction -- problems with memory, concentration, processing of information -- but the effects of non-cardiac surgeries on brain function are not as well-understood,” said Terri Monk, M.D., an anesthesiologist at Duke and the Durham Veterans Affairs Medical Center, and lead investigator on the study.

“Our study found that increasing age put patients in this population at greater risk for cognitive problems and this is significant because the elderly are the fastest growing segment of the population. We know that half of all people 65 and older will have at least one surgery in their lifetime,” Monk added.

For the study, the researchers measured memory and the ability to process information in more than 1000 adult patients of different ages. Patients were tested preoperatively, at the time of hospital discharge, and three months after surgery. More than 200 control subjects took the same tests at the same frequency, but did not undergo surgery or anesthesia.

It was found that many of the young, middle-aged and elderly patients experienced postoperative cognitive dysfunction (POCD) at the time they left the hospital. However, three months later, those aged 60 and older were more than twice as likely to exhibit POCD.

The study also found that those with POCD at both the time of hospital discharge and three months after surgery also were more likely to die within the first year after surgery.

“The large difference in the prevalence of POCD between what we termed the elderly -- those aged 60 and over -- and the younger groups we were studying validates the general perception that the elderly are predisposed to cognitive impairment after major surgery,” Monk said.

The researchers published their findings in the January 1, 2008 issue of the journal Anesthesiology.

Source-ANI
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