Cognitive Decline Speeds Up Following Postoperative Delirium

2023-03-30

THURSDAY, March 30, 2023 -- Postoperative delirium is associated with accelerated cognitive decline in older adults, according to a study published online March 20 in JAMA Internal Medicine.

Zachary J. Kunicki, Ph.D., from the Warren Alpert Medical School of Brown University in Providence, Rhode Island, and colleagues examined the patterns and pace of cognitive decline up to 72 months after major elective surgery in 560 older adults (older than 70 years).

The researchers found that 24 percent of participants developed postoperative delirium. There were differences observed in acute, post-short-term, intermediate, and longer-term cognitive change from the time of surgery that were associated with the development of postoperative delirium. When adjusting for practice and recovery effects, long-term cognitive change occurred at a pace of about −1.0 general cognitive performance (GCP) units per year. Significantly faster long-term cognitive change was seen for participants with delirium (an additional −0.4 GCP units or −1.4 units per year). Delirium was associated with a 40 percent acceleration in the slope of cognitive decline out to 72 months postoperatively.

"We cannot be sure whether delirium directly causes subsequent cognitive decline, or whether patients with preclinical brain disease are more likely to develop delirium," the authors write. "Future research is needed to understand the causal pathway between delirium and cognitive decline."

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Posted March 2023

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