Determinants of Post-Operative Cognitive Decline in Elderly People.
J Prev Alzheimers Dis
; 8(3): 322-228, 2021.
Article
em En
| MEDLINE
| ID: mdl-34101790
ABSTRACT
BACKGROUND:
Surgery and anesthesia can result in temporary or permanent deterioration of the cognitive functions, for which causes remain unclear.OBJECTIVES:
In this pilot study, we analyzed the determinants of cognitive decline following a non-emergency elective prosthesis implantation surgery for hip or knee.DESIGN:
Prospective single-center study investigating psychomotor response time and changes in MoCA scores between the day before (D-1) and 2 days after (D+2) following surgery at the Lariboisière Hospital (Paris, France).PARTICIPANTS:
60 patients (71.9±7.1-year-old, 72% women) were included. MEASUREMENTS Collected data consisted in sociodemographic data, treatments, comorbidities and the type of anesthesia (local, general or both). Furthermore, we evaluated pain and well-being before as well as after the surgery using point scales.RESULTS:
Post-operative (D+2) MoCA scores were significantly lower than pre-operative ones (D-1) with a median difference of 2 pts [IQR]=4pts, (p<0.001), we found no significant difference between locoregional and general anesthesia. Pre-operative benzodiazepine or anticholinergic treatments were also associated to a drop in MoCA scores (p=0.006). Finally, the use of ketamine during anesthesia (p=0.043) and the well-being (p=0.006) evaluated before intervention, were both linked to a reduced cognitive impact.CONCLUSION:
In this pilot study, we observed a post-operative short-term cognitive decline following a lower limb surgery. We also identified pre and perioperative independent factors linked to cognitive decline following surgery. In a next stage, a larger cohort should be used to confirm the impact of these factors on cognitive decline.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Cognição
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Disfunção Cognitiva
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Anestesia Geral
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article