Cognitive decline after major oncological surgery in the elderly.
Eur J Cancer
; 86: 394-402, 2017 11.
Article
em En
| MEDLINE
| ID: mdl-29100194
ABSTRACT
BACKGROUND:
Elderly patients undergoing oncological surgery experience postoperative cognitive decline. The aims of this study were to examine the incidence of cognitive decline 3 months after surgery and identify potential patient-, disease- and surgery-related risk factors for postoperative cognitive decline in onco-geriatric patients.METHODS:
A consecutive series of elderly patients (≥65 years) undergoing surgery for the removal of a solid tumour were included (n = 307). Cognitive performance was assessed pre-operatively and 3 months postoperatively. Postoperative decline was defined as a decline in scores of cognitive tests of ≥25% on ≥2 of 5 tests.RESULTS:
Of the patients who had completed the assessments, 117 (53%, 95% confidence interval [CI] 47-60) had improved cognitive test scores, whereas 26 (12%, 95% CI 7.6-16) showed cognitive decline at 3 months postoperatively. In patients aged >75 years, the incidence of overall cognitive decline 3 months postoperatively was 18% (95% CI 9.3-27). In patients with lower pre-operative Mini-Mental State Examination (MMSE) score (≤26) the incidence was 37% (95% CI 18-57), and in patients undergoing major surgery it was 18% (95% CI 10.6-26). Of the cognitive domains, executive function was the most vulnerable to decline.CONCLUSION:
About half of the elderly patients show improvement in postoperative cognitive performance after oncological surgery, whereas 12% show cognitive decline. Advanced age, lower pre-operative MMSE score and major surgery are risk factors for cognitive decline at 3 months postoperatively and should be taken into account in the clinical decision-making progress. Research to develop interventions to preserve quality of life should focus on this high-risk subpopulation.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos Operatórios
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Envelhecimento
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Cognição
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Disfunção Cognitiva
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Neoplasias
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Holanda