Cognitive decline in the elderly after surgery and anaesthesia: results from the Oxford Project to Investigate Memory and Ageing (OPTIMA) cohort.

Patel D., Lunn AD., Smith AD., Lehmann DJ., Dorrington KL.

Concerns have been raised about the effects on cognition of anaesthesia for surgery, especially in elderly people. We recorded cognitive decline in a cohort of 394 people (198 women) with median (IQR) age at recruitment of 72.6 (66.6-77.8) years, of whom 109 had moderate or major surgery during a median (IQR) follow-up of 4.1 (2.0-7.6) years. Cognitive decline was more rapid in people who on recruitment were: older, p = 0.0003; male, p = 0.027; had worse cognition, p < 0.0001; or carried the ε4 allele of apoliprotein E (APOEε4), p = 0.008; and after an operation if cognitive impairment was already diagnosed, p = 0.0001. Cognitive decline appears to accelerate after surgery in elderly patients diagnosed with cognitive impairment, but not other elderly patients.

DOI

10.1111/anae.13571

Type

Journal article

Journal

Anaesthesia

Publication Date

10/2016

Volume

71

Pages

1144 - 1152

Keywords

anaesthesia, cognitive decline, surgery, Age Factors, Aged, Aging, Anesthesia, Cognitive Dysfunction, Cohort Studies, Female, Follow-Up Studies, Geriatric Assessment, Humans, Male, Memory, Neuropsychological Tests, Postoperative Complications, Risk Factors, Sex Factors

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