title: Cognitive decline in the elderly after surgery and anaesthesia: results from the Oxford Project to Investigate Memory and Ageing (OPTIMA) cohort.
abstract: Concerns have been raised about the effects on cognition of anaesthesia for surgery, especially in elderly people. We recorded cognitive decline in a cohort of 394 people (198 women) with median (IQR) age at recruitment of 72.6 (66.6-77.8) years, of whom 109 had moderate or major surgery during a median (IQR) follow-up of 4.1 (2.0-7.6) years. Cognitive decline was more rapid in people who on recruitment were: older, p = 0.0003; male, p = 0.027; had worse cognition, p < 0.0001; or carried the ε4 allele of apoliprotein E (APOEε4), p = 0.008; and after an operation if cognitive impairment was already diagnosed, p = 0.0001. Cognitive decline appears to accelerate after surgery in elderly patients diagnosed with cognitive impairment, but not other elderly patients.
authors: Northwick Park Hospital, Harrow, UK.
authors: D
authors: D
authors: Patel
authors: Department of Statistics, University of Oxford, Oxford, UK.
authors: A D
authors: AD
authors: Lunn
authors: Oxford Project to Investigate Memory and Ageing, Department of Pharmacology, University of Oxford, Oxford, UK.
authors: A D
authors: AD
authors: Smith
authors: Oxford Project to Investigate Memory and Ageing, Department of Pharmacology, University of Oxford, Oxford, UK.
authors: D J
authors: DJ
authors: Lehmann
authors: Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK. keith.dorrington@dpag.ox.ac.uk.|Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, UK. keith.dorrington@dpag.ox.ac.uk.
authors: K L
authors: KL
authors: Dorrington
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging / Q000523:psychology*; D000758:Anesthesia / Q000009:adverse effects*; D060825:Cognitive Dysfunction / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors
keywords: anaesthesia; cognitive decline; surgery