Long-term Cognitive Trajectories in Older Adults After Surgery: A Population-based Cohort Study.

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Alzheimer Disease & Associated Disorders Pub Date : 2025-01-09 DOI:10.1097/WAD.0000000000000655

Parthasarathy D Thirumala, Beth E Snitz, Erin Jacobsen, Chung-Chou H Chang, Yue-Fang Chang, Mary Ganguli

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引用次数: 0

Abstract

Introduction: Postoperative cognitive decline (POCD) is a common, but often unrecognized condition after surgery. We evaluate postsurgical cognitive changes in a longitudinal population-based study.

Methods: The study cohort comprises an age-stratified population-based random sample of individuals aged 65+ years from a small-town region of the United States. We identified as cases those participants who, during annual assessments, self-reported having undergone surgery under general anesthesia during the preceding year. We identified as controls those who reported no surgery for at least 6 consecutive years. The outcome variable changed over time (4 y) in annual cognitive test composite scores encompassing the domains of attention/processing speed, executive function, memory, language, and visuospatial functions, which were modeled using Generalized Estimating Equations.

Results: A total of 436 participants had the required cognitive data; 179 participants (cases) had undergone surgery, while 257 participants (controls) had not undergone surgery. After adjusting for age, years of education, gender, race, heart failure, irregular heartbeat, and stroke, participants who underwent surgery had a greater decline in executive function, memory, and attention over a 2-year period.

Discussion: Participants who underwent surgery had a significant subsequent decline in cognitive function over the long term.

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老年人手术后的长期认知轨迹：一项基于人群的队列研究。

术后认知能力下降（POCD）是一种常见的，但往往未被认识到的术后症状。我们在一项基于人群的纵向研究中评估术后认知变化。方法：研究队列包括一个年龄分层的基于人口的随机样本，来自美国一个小镇地区的65岁以上的个体。我们将那些在年度评估中自我报告在前一年接受过全身麻醉手术的参与者确定为病例。我们将那些至少连续6年未接受手术的患者作为对照组。年度认知测试综合得分的结果变量随时间（4年）而变化，包括注意/处理速度、执行功能、记忆、语言和视觉空间功能等领域，这些结果变量使用广义估计方程建模。结果：共有436名参与者具有所需的认知数据；179例（病例）接受了手术，257例（对照组）未接受手术。在调整了年龄、受教育年限、性别、种族、心力衰竭、心律不齐和中风等因素后，接受手术的参与者在执行功能、记忆力和注意力方面的下降幅度更大。讨论：接受手术的参与者在长期的认知功能上有明显的下降。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer Disease & Associated Disorders 医学-病理学

CiteScore

3.10

自引率

4.80%

发文量

期刊介绍： Alzheimer Disease & Associated Disorders is a peer-reviewed, multidisciplinary journal directed to an audience of clinicians and researchers, with primary emphasis on Alzheimer disease and associated disorders. The journal publishes original articles emphasizing research in humans including epidemiologic studies, clinical trials and experimental studies, studies of diagnosis and biomarkers, as well as research on the health of persons with dementia and their caregivers. The scientific portion of the journal is augmented by reviews of the current literature, concepts, conjectures, and hypotheses in dementia, brief reports, and letters to the editor.