Does mild cognitive impairment increase the risk of developing postoperative cognitive dysfunction?

被引:71
作者
Bekker, Alex [1 ]
Lee, Cynthia [1 ]
de Santi, Susan [2 ]
Pirraglia, Elizabeth [2 ]
Zaslavsky, Alexander [1 ]
Farber, Sonya [1 ]
Haile, Michael [1 ]
de Leon, Mony J. [2 ]
机构
[1] NYU, Dept Anesthesiol, Med Ctr, New York, NY 10016 USA
[2] NYU, Dept Psychiat, Med Ctr, New York, NY 10016 USA
关键词
Postoperative complications; Cognitive impairment; Working memory; Neurocognitive testing; RATING-SCALE; PREDICTION; MEMORY; MCI;
D O I
10.1016/j.amjsurg.2009.07.042
中图分类号
R61 [外科手术学];
学科分类号
摘要
BACKGROUND: Increasingly, postoperative cognitive dysfunction (POCD) is recognized as a complication after surgery in the elderly. We sought to determine whether patients with mild cognitive impairment (MCI) would have an accelerated progression of dementia postoperatively when compared with the patients without MCI. METHODS: The Center for Brain Health at the New York University (NYU) Medical Center maintains records of volunteers who undergo a series of neurological assessments. We reviewed records of 670 patients who received at least 2 evaluations and whose surgery occurred before the second assessment. Longitudinal differences of several cognitive domains were examined. RESULTS: Individuals with MCI and surgery had a greater decline in performance on the Digit Span Forward test compared with those with MCI without surgery on their postoperative evaluation (F-3,F-158 = 3.12, P = .03). No performance changes were detected in the normal subjects. CONCLUSION: These preliminary findings suggest that surgery negatively impacts attention/concentration in patients with MCI but not in normal individuals. This is the first study that identified a specific subgroup of patients who are predisposed to POCD. (C) 2010 Elsevier Inc. All rights reserved.
引用
收藏
页码:782 / 788
页数:7
相关论文
共 27 条
[11]   Analyzing Digit Span components for assessment of attention processes [J].
Hale, JB ;
Hoeppner, JB ;
Fiorello, CA .
JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT, 2002, 20 (02) :128-143
[12]   A RATING SCALE FOR DEPRESSION [J].
HAMILTON, M .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1960, 23 (01) :56-62
[13]   Special issue on postoperative cognitive dysfunction - Selected reports from the Journal-sponsored symposium [J].
Maze, Mervyn ;
Todd, Michael M. .
ANESTHESIOLOGY, 2007, 106 (03) :418-420
[14]   Long-term postoperative cognitive dysfunction in the elderly: ISPOCD1 study [J].
Moller, JT ;
Cluitmans, P ;
Rasmussen, LS ;
Houx, P ;
Rasmussen, H ;
Canet, J ;
Rabbitt, P ;
Jolles, J ;
Larsen, K ;
Hanning, CD ;
Langeron, O ;
Johnson, T ;
Lauven, PM ;
Kristensen, PA ;
Biedler, A ;
van Beem, H ;
Fraidakis, O ;
Silverstein, JH ;
Beneken, JEW ;
Gravenstein, JS .
LANCET, 1998, 351 (9106) :857-861
[15]   Predictors of cognitive dysfunction after major noncardiac surgery [J].
Monk, Terri G. ;
Weldon, B. Craig ;
Garvan, Cyndi W. ;
Dede, Duane E. ;
van der Aa, Maria T. ;
Heilman, Kenneth M. ;
Gravenstein, Joachim S. .
ANESTHESIOLOGY, 2008, 108 (01) :18-30
[16]   Mild cognitive impairment as a clinical entity and treatment target [J].
Petersen, RC ;
Morris, JC .
ARCHIVES OF NEUROLOGY, 2005, 62 (07) :1160-1163
[17]   Current concepts in mild cognitive impairment [J].
Petersen, RC ;
Doody, R ;
Kurz, A ;
Mohs, RC ;
Morris, JC ;
Rabins, PV ;
Ritchie, K ;
Rossor, M ;
Thal, L ;
Winblad, B .
ARCHIVES OF NEUROLOGY, 2001, 58 (12) :1985-1992
[18]   Type and severity of cognitive decline in older adults after noncardiac surgery [J].
Price, Catherine C. ;
Garvan, Cynthia W. ;
Monk, Terri G. .
ANESTHESIOLOGY, 2008, 108 (01) :8-17
[19]  
REISBERG B, 1988, PSYCHOPHARMACOL BULL, V24, P629
[20]  
REISBERG B, 1993, NEUROSCI RES COMMUN, V13, pS51