title: Postoperative cognitive dysfunction after total joint arthroplasty in the elderly: a meta-analysis.
abstract: This meta-analysis consolidated the research on postoperative cognitive dysfunction (POCD) following total joint arthroplasty (TJA). Data from 17 studies that assessed cognition pre- and post-surgery in TJA patients alone (15 studies) or matched TJA and control groups (2 studies) were analysed. Results were grouped by cognitive domain (memory, attention, language, speed, general cognition) and follow-up interval (pre-discharge, 3-6 months post-surgery). The TJA data revealed small declines in reaction time and general cognition pre-discharge, but no evidence of decline 3-6 months post-surgery. Very limited TJA and Control data indicated no group differences in the changes to performance over time; however, the TJA group was cognitively compromised pre- and post-surgery compared to Controls. Further appropriately controlled research is required to clarify whether POCD commonly occurs after TJA.
authors.affiliation: School of Psychology, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Julia E
authors.initials: JE
authors.lastname: Scott
authors.affiliation: School of Psychology, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Jane L
authors.initials: JL
authors.lastname: Mathias
authors.affiliation: Department of Clinical Psychology, Flinders Medical Centre, School of Medicine, South Australia, Australia.
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Kneebone
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D011184:Postoperative Period
keywords: elderly; meta-analysis; outcomes; post-operative cognitive dysfunction; total joint arthroplasty