Deborah M Oyeyemi1,2, Mary Cooter1, Stacey Chung1, Heather E Whitson2,3, Jeffrey N Browndyke4,5, Michael J Devinney1, Patrick J Smith4, Grant E Garrigues6, Eugene Moretti1, Judd W Moul7, Harvey Jay Cohen2,3, Joseph P Mathew1, Miles Berger1,3,5. 1. Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA. 2. Department of Medicine, Duke University Medical Center, Durham, NC, USA. 3. Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA. 4. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA. 5. Center for Cognitive Neuroscience, Duke Institute for Brain Sciences, Duke University, Durham, NC, USA. 6. Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA. 7. Department of Surgery, Duke University Medical Center, Durham, NC, USA.
Abstract
OBJECTIVE: To determine the relationship between affective measures and cognition before and after non-cardiac surgery in older adults. METHODS: Observational prospective cohort study in 103 surgical patients age ≥ 60 years old. All participants underwent cognitive testing, Center for Epidemiologic Studies-Depression, and State Anxiety Inventory screening before and 6 weeks after surgery. Cognitive test scores were combined by factor analysis into 4 cognitive domains, whose mean was defined as the continuous cognitive index (CCI). Postoperative global cognitive change was defined by CCI change from before to after surgery, with negative CCI change indicating worsened postoperative global cognition and vice versa. RESULTS: Lower global cognition before surgery was associated with greater baseline depression severity (Spearman's r = -0.30, p = 0.002) and baseline anxiety severity (Spearman's r = -0.25, p = 0.010), and these associations were similar following surgery (r = -0.36, p < 0.001; r = -0.26, p = 0.008, respectively). Neither baseline depression or anxiety severity, nor postoperative changes in depression or anxiety severity, were associated with pre- to postoperative global cognitive change. CONCLUSIONS: Greater depression and anxiety severity were each associated with poorer cognitive performance both before and after surgery in older adults. Yet, neither baseline depression or anxiety symptoms, nor postoperative change in these symptoms, were associated with postoperative cognitive change.
OBJECTIVE: To determine the relationship between affective measures and cognition before and after non-cardiac surgery in older adults. METHODS: Observational prospective cohort study in 103 surgical patients age ≥ 60 years old. All participants underwent cognitive testing, Center for Epidemiologic Studies-Depression, and State Anxiety Inventory screening before and 6 weeks after surgery. Cognitive test scores were combined by factor analysis into 4 cognitive domains, whose mean was defined as the continuous cognitive index (CCI). Postoperative global cognitive change was defined by CCI change from before to after surgery, with negative CCI change indicating worsened postoperative global cognition and vice versa. RESULTS: Lower global cognition before surgery was associated with greater baseline depression severity (Spearman's r = -0.30, p = 0.002) and baseline anxiety severity (Spearman's r = -0.25, p = 0.010), and these associations were similar following surgery (r = -0.36, p < 0.001; r = -0.26, p = 0.008, respectively). Neither baseline depression or anxiety severity, nor postoperative changes in depression or anxiety severity, were associated with pre- to postoperative global cognitive change. CONCLUSIONS: Greater depression and anxiety severity were each associated with poorer cognitive performance both before and after surgery in older adults. Yet, neither baseline depression or anxiety symptoms, nor postoperative change in these symptoms, were associated with postoperative cognitive change.
Entities:
Keywords:
anxiety; depression; older adults; postoperative cognitive dysfunction; surgery
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