Navigation Links
Older surgical patients at greater risk for developing cognitive problems
Date:1/2/2008

DURHAM, N.C. -- 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, according to a new study led by Duke University Medical Center researchers.

The study 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.

The researchers published their findings in the January 1, 2008 issue of the journal Anesthesiology and the results were published early online on December 27, 2007 on the journals Web site. The article is accompanied by a supportive editorial and a companion article detailing the types of cognitive dysfunction that developed and the effects on patients daily lives. The study was funded by the National Institute on Aging, the Anesthesia Patient Safety Foundation and the I. Heerman Foundation.

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.

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

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. POCD was more common among those patients with lower educational level and a history of a stroke that had left no noticeable neurologic impairment.

Education protected against postoperative cognitive problems, likely because education may provide an opportunity to condition the brain, and better equip it to withstand injury, much like physical exercise has a protective effect on the body, Monk said.

The reasons why cognitive decline is associated with early death are not completely understood, but its possible that patients with prolonged cognitive dysfunction might be less able to take medicines correctly or may not recognize the need to seek medical care for symptoms of complications, Monk said.

Studies on normal aging have shown a link between abrupt cognitive decline and early death, so we speculated that surgery-related cognitive dysfunction might have the same effect, she said.

Why some patients suffer POCD is not known, but one hypothesis is that surgery and the accompanying anesthesia might cause inflammation in the brain that can affect the patients ability to learn, retain or remember information, Monk said.

Now that the implications of long-term POCD are better understood, doctors must devise strategies to prevent or mitigate the detrimental effects of surgery and anesthesia on the aging brain, Monk said. The types of interventions and how to implement them will be the subject of further research, she said.


'/>"/>

Contact: Lauren Shaftel Williams
lauren.shaftel@duke.edu
919-684-4966
Duke University Medical Center
Source:Eurekalert

Related medicine news :

1. Ability to cope with stress can increase good cholesterol in older white men, study finds
2. Many Older Americans Have Active Sex Lives
3. Good Cholesterol Wont Help Heavy-Drinking Older Men
4. Manor Care, Inc. Announces Record Date for Special Stockholder Meeting
5. Arrow International Urges Shareholders To Vote for Approval of the $45.50 Teleflex Inc. Merger and for the Current Board of Directors
6. Frequent alcohol consumption increases cancer risk in older women
7. Zimmer Holdings Offer and ORTHOsoft Directors Circular Mailed to Shareholders
8. ISS and Glass Lewis Recommend Cholestech Stockholders Vote FOR Merger
9. Glass Lewis Recommends Arrow Shareholders Vote on the White Proxy Card for Merger With Teleflex and for Current Board of Directors at Arrow Annual Meeting
10. Drug-free treatments offer hope for older people in pain
11. United Medicorp, Inc.s Shareholders Approve All Proposals
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/23/2017)... ... May 23, 2017 , ... Orbita’s Nathan Treloar will discuss ... 2017 in San Francisco. Titled Connected Health and IoT: Technology Innovators and Disruption ... hosted by Parks Associates, a market research and consulting firm specializing in emerging consumer ...
(Date:5/23/2017)... ... May 23, 2017 , ... New patients ... SPEED System™ Orthodontics, with or without a referral, from the multi-specialty Dr. Smile ... CA, who is skilled in providing patients with the custom, convenient and long-lasting ...
(Date:5/23/2017)... ... 23, 2017 , ... Patients in need of a pulpotomy in ... an appointment, with or without a referral. Dr. Cotey is a respected dental provider ... as a healthy alternative to a tooth extraction. , When a child has a ...
(Date:5/22/2017)... Mt. Kisco, NY (PRWEB) , ... May 22, 2017 , ... ... are urged to receive relaxing sedation dentistry in Mt. Kisco, NY from Advanced ... can be administered for a variety of treatments. One or more sedation methods may ...
(Date:5/22/2017)... ... May 22, 2017 , ... Today, Our Urgent Care celebrates the grand ... public ribbon cutting ceremony. Since opening over a month ago, Our Urgent Care ... room. The new Our Urgent Care walk-in clinic is located at 3195 Phoenix ...
Breaking Medicine News(10 mins):
(Date:5/11/2017)... May 11, 2017  Thornhill Research Inc. ( ... awarded an $8,049,024 USD five-year, firm-fixed-priced, indefinite-quantity/indefinite-delivery contract ... Canadian Commercial Corporation (CCC) ( Ottawa, Ontario, ... to administer general anesthesia to patients requiring emergency ... "The US Marine Corps have been a longtime ...
(Date:5/10/2017)... Radiology has become the number one diagnostic ... spiraled to the number one ranking as a result.  ... before as the most complete and reliable method for ... back pain an MRI may confirm a suspected herniated ... in entirely different treatment protocols.  In these circumstances, patients ...
(Date:5/9/2017)... May 9, 2017  Oramed Pharmaceuticals Inc. (NASDAQ: ... clinical-stage pharmaceutical company focused on the development of ... Canadian Intellectual Property Office has granted Oramed a ... of Exenatide". The patent covers Oramed,s invention of ... GLP-1 is an incretin hormone that stimulates the ...
Breaking Medicine Technology: