Cognitive impairment after surgery
Older persons, in particular, tend to suffer from memory lapses and other types of cognitive impairment after undergoing surgical procedures (postoperative cognitive dysfunction, POCD). Surgery has been performed on older patients much more commonly in recent years than ever before, and their pre- and postoperative care has become an important matter. Ingrid Rundshagen, an anesthesiologist, has surveyed the available literature to find out what kinds of patients are more likely to have cognitive impairment after surgery, and how the clinical manifestations should best be dealt with. Her summarized findings can be read in the current edition of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2014; 111: 119).
Patients over age 60 with pre-existing cerebral, cardiac, or vascular disease are more likely than others to suffer from cognitive impairment after surgery. Alcohol abuse is a further risk factor. Nearly 13% of all persons over age 60 who undergo surgery still have some degree of cognitive dysfunction three months later. The available evidence also indicates that postoperative recovery takes considerably longer if the patient has POCD. The author recommends that new clinical test instruments should be developed to help identify patients at risk. Preventive strategies to lower the incidence of POCD should also be developed.