High-Risk Surgery May Be Tied to Cognitive Decline in Older Adults

Previous evidence has shown that older adults, who account for 60% of postoperative complications in the United States, have the highest risk for prolonged recovery after surgery.

Now, new research presented at the American College of Surgeons Clinical Congress 2018 suggests that older adults who undergo high-risk surgery may also be at risk for moderate functional and cognitive declines post-procedure.

YOU MIGHT LIKE
Visual Impairment Linked to Cognitive Decline
Diabetes May Quicken Cognitive Decline

“Knowledge of such trajectories may inform preoperative discussions and prognosis,” the authors of the study wrote.

Their findings emerged from an analysis of 1992-2012 Health and Retirement Survey data and Medicare data on patients older than 65 years who underwent high-risk elective surgery. Controls who did not undergo surgery were propensity-matched 3:1 with surgery recipients, using traditional predictors of functional and cognitive decline.

The relationship of surgery and complications with functional and cognitive decline was assessed via logistic regression.

Of the 1589 patients who underwent surgery, 744 (46.8%) had a complication. Results of the study showed that surgery recipients had an unadjusted rate of functional decline of 26.3% compared with 18.8% among controls. Approximately 22.0% of surgery recipients experienced cognitive decline vs 19.4% of controls.

Multivariable analysis findings demonstrated that surgery independently predicted functional and cognitive decline (odds ratios: 1.53 and 1.16, respectively).

Separate models for the surgery group indicated that complications had no significant impact on function or cognition in the long-term.

—Christina Vogt

Reference:

Suwanabol PA, Li Y, Abrahamse P, Dimick JB. Functional and cognitive decline among older adults undergoing high-risk surgery. J Am Coll Surg. 2018;227(4 suppl. 2):e30. https://doi.org/10.1016/j.jamcollsurg.2018.08.077