Does mild cognitive impairment increase the risk of developing postoperative cognitive dysfunction?
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(3,158) = 3.12, P = .03). No performance changes were detected in the normal subjects.


CONCLUSIONS
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.
Bekker
Alex
A
Department of Anesthesiology, New York University Medical Center, New York, NY, USA. alex.bekker@nyumc.org
Lee
Cynthia
C
de Santi
Susan
S
Pirraglia
Elizabeth
E
Zaslavsky
Alexander
A
Farber
Sonya
S
Haile
Michael
M
de Leon
Mony J
MJ
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003704:Dementia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003952:Diagnostic Imaging; D018450:Disease Progression; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors