The Frequency of Cognitive Impairment after Anesthesia in Patients Over 60 Years of Age, and Determination of Risk Factors

Document Type : Original Article (s)

Authors

1 Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Cognitive impairment is one of the most common, severe, and life-threatening complications after surgery that understanding the factors affecting it, reduces the incidence of this complication. Therefore, the aim of this study was to investigate the prevalence of cognitive impairment after anesthesia in patients over 60 years of age, and determination of risk factors.Methods: The study included 384 patients older than 60 years of age undergoing surgery. Mini mental state examination (MMSE) questionnaire was used to assess demographic and cognitive impairment before, and one and three days after the surgery. To compare quantities and qualitative data, t, chi-square, and Mann-Whitney tests were recruited.Findings: The frequency of mild and moderate cognitive impairment was 21.6 and 1.8, 38.8 and 12.5, and 46.6 and 5.2 percent before, and one and three days after the surgery, respectively. The high prevalence of cognitive impairment after surgery had significant correlation with older age, female gender, low education levels, being single, smoking and alcohol consumption, general anesthesia, and longer hospitalization (P < 0.050 for all).Conclusion: Based on these findings, we can say that the prevalence of cognitive impairment in the elderly was high after surgery. Moreover, we found that older age, female gender, low education, single people, history of smoking and alcohol consumption, general anesthesia, and length of stay in hospital increased cognitive impairment in patients over age 60 years of age.

Keywords

References

  1. Engelhard K, Werner C. Postoperative cognitive dysfunction. Anaesthesist 2005; 54(6): 588-94. [In German].
  2. Norkiene I, Samalavicius R, Misiuriene I, Paulauskiene K, Budrys V, Ivaskevicius J. Incidence and risk factors for early postoperative cognitive decline after coronary artery bypass grafting. Medicina (Kaunas) 2010; 46(7): 460-4.
  3. Steinmetz J, Jespersgaard C, Dalhoff K, Hedley P, Abildstrom H, Christiansen M, et al. Cytochrome P450 polymorphism and postoperative cognitive dysfunction. Minerva Anestesiol 2012; 78(3): 303-9.
  4. Wang W, Wang Y, Wu H, Lei L, Xu S, Shen X, et al. Postoperative cognitive dysfunction: current developments in mechanism and prevention. Med Sci Monit 2014; 20: 1908-12.
  5. Bilotta F, Doronzio A, Stazi E, Titi L, Zeppa IO, Cianchi A, et al. Early postoperative cognitive dysfunction and postoperative delirium after anaesthesia with various hypnotics: study protocol for a randomised controlled trial--the PINOCCHIO trial. Trials 2011; 12: 170.
  6. Steiner LA. Postoperative delirium. Part 1: Pathophysiology and risk factors. Eur J Anaesthesiol 2011; 28(9): 628-36.
  7. Rudolph JL, Marcantonio ER, Culley DJ, Silverstein JH, Rasmussen LS, Crosby GJ, et al. Delirium is associated with early postoperative cognitive dysfunction. Anaesthesia 2008; 63(9): 941-7.
  8. Bi Y, Liu S, Yu X, Wu M, Wang Y. Adaptive and regulatory mechanisms in aged rats with postoperative cognitive dysfunction. Neural Regen Res 2014; 9(5): 534-9.
  9. Ritchie K, Polge C, de Roquefeuil G, Djakovic M, Ledesert B. Impact of anesthesia on the cognitive functioning of the elderly. Int Psychogeriatr 1997; 9(3): 309-26.
  10. Kaplan HI, Sadock BJ, Sadock VA. Kaplan and Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry. 9th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2003.
  11. Townsend CM, Sabiston DC. Sabiston review of surgery. 16th ed. Philadelphia, PA: Saunders; 2001.
  12. Dyer CB, Ashton CM, Teasdale TA. Postoperative delirium. A review of 80 primary data-collection studies. Arch Intern Med 1995; 155(5): 461-5.
  13. Morimoto Y, Yoshimura M, Utada K, Setoyama K, Matsumoto M, Sakabe T. Prediction of postoperative delirium after abdominal surgery in the elderly. J Anesth 2009; 23(1): 51-6.
  14. Biedler A, Juckenhofel S, Larsen R, Radtke F, Stotz A, Warmann J, et al. Postoperative cognition disorders in elderly patients. The results of the "International Study of Postoperative Cognitive Dysfunction" ISPOCD 1). Anaesthesist 1999; 48(12): 884-95. [In German].
  15. Taban H, Ahmadzadeh GH, Tavasoli MH. Pre and post operation cognitive disorder in older persons. Hormozgan Med J 2003; 7(3): 135-9. [In Persian].
  16. Hassani E, Mahoori A, Noroozinia H, Mehdizadeh H, Sepasi N. Evaluation of risk factors for adverse neurologic outcome after cardiac surgery. Urmia Med J 2010; 21(2): 249-53. [In Persian].
  17. Naghibi K, Shafa A, Hirmanpour A, Sabaghi B. The impact of general anesthesia vs local anesthesia with intravenous sedation on the incidence of postoperative cognitive dysfunction after cataract surgery in elderly patients. J Isfahan Med Sch 2016; 34(372): 134-42. [In Persian].
  18. Derakhshanfar A, Ghaleiha A, Niayesh A, Alizadeh S, Goodarzi MT, Ghorbanpoor M. Assessment of the frequency of cognitive disorder in older patients before and after surgery in hamadan educational hospitals. Iran J Surg 2010; 18(4): 9-17. [In Persian].
  19. Moller JT, Cluitmans P, Rasmussen LS, Houx P, Rasmussen H, Canet J, et al. Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study of Post-Operative Cognitive Dysfunction. Lancet 1998; 351(9106): 857-61.
Journal of Isfahan Medical School
Volume 36, Issue 487 - Serial Number 487
May and June 2018
Pages 779-786

Files

History

  • Receive Date: 17 November 2016
  • Revise Date: 02 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics