Effects of surgery on the mental status of older persons. A meta-analytic review.
The data bases of 18 empirical studies were combined into one comprehensive data set and subjected to meta-analysis. The following trends were observed: (1) surgery has a significantly decompensating impact on the mental status of older persons, and the average effect size observed is modest (r = .37); (2) for all mental status measures included in the review (cognition, delirium and affect), effect size appears to be significantly moderated by patient age; (3) patient sex may be predictive of the kind of mental impairment that is most likely to occur within an older surgery population, with women manifesting a greater affinity for delirious and men for cognitive decompensation; (4) most existing research within this domain of study is either purely descriptive or anecdotal: of 46 studies reviewed, only 18, or 39.1% of the total published output, were of sufficient methodologic rigor to allow for scientifically valid effect-size computations. The implications of these findings for future research are discussed.
Cryns
A G
AG
Multidisciplinary Center on Aging, School of Medicine, State University of New York, Buffalo 14214.
Gorey
K M
KM
Goldstein
M Z
MZ
D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D015201:Meta-Analysis as Topic; D011183:Postoperative Complications / Q000523:psychology*; D012803:Sick Role; D013514:Surgical Procedures, Operative / Q000523:psychology*