Abstract
There is evidence that older people in particular have a higher risk of cognitive dysfunction
after surgery under general anaesthesia. We have investigated the severity and character of
postoperative cognitive dysfunction after major non-cardiac surgery in patients older than
65 yr. Also, cognitive complaints were studied. Cognitive function was assessed using cognitive
tests measuring memory and attention, such as ability to shift between two sequences, ability
to ward off distractions, simple cognitive speed and speed of general information processing.
These tests were performed before, 1 week (short-term) and 3 months (long-term) after
surgery. Cognitive performance of the patients was compared with that of healthy subjects
not undergoing surgery who were also subjected to repeated cognitive measurements. After
1 week, patients had a poorer performance on tests measuring simple cognitive speed and
speed of general information processing. Three months after surgery, patients and controls
showed improved cognitive performance compared with the first measurement. These results
suggest that major non-cardiac surgery in older patients causes short-term but not long-term
cognitive dysfunction. However, after 6 months, 14 of 48 patients (29%) reported having
experienced a decline in cognitive abilities after discharge from hospital. Eight of these 14
patients (17%) were still experiencing these cognitive complaints and reported ‘not being the
same since the operation’. These findings emphasize that cognitive complaints after major
surgery may not reflect actual changes in cognitive performance but may be caused by other
factors such as depression or awareness of age-related changes.
after surgery under general anaesthesia. We have investigated the severity and character of
postoperative cognitive dysfunction after major non-cardiac surgery in patients older than
65 yr. Also, cognitive complaints were studied. Cognitive function was assessed using cognitive
tests measuring memory and attention, such as ability to shift between two sequences, ability
to ward off distractions, simple cognitive speed and speed of general information processing.
These tests were performed before, 1 week (short-term) and 3 months (long-term) after
surgery. Cognitive performance of the patients was compared with that of healthy subjects
not undergoing surgery who were also subjected to repeated cognitive measurements. After
1 week, patients had a poorer performance on tests measuring simple cognitive speed and
speed of general information processing. Three months after surgery, patients and controls
showed improved cognitive performance compared with the first measurement. These results
suggest that major non-cardiac surgery in older patients causes short-term but not long-term
cognitive dysfunction. However, after 6 months, 14 of 48 patients (29%) reported having
experienced a decline in cognitive abilities after discharge from hospital. Eight of these 14
patients (17%) were still experiencing these cognitive complaints and reported ‘not being the
same since the operation’. These findings emphasize that cognitive complaints after major
surgery may not reflect actual changes in cognitive performance but may be caused by other
factors such as depression or awareness of age-related changes.
| Original language | English |
|---|---|
| Pages (from-to) | 867-874 |
| Number of pages | 8 |
| Journal | British Journal of Anaesthesia |
| Volume | 82 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 1 Jan 1999 |