Small mental decline associated with major surgery, study finds

Uncertainty that surgery may impact cognitive functioning is apparent in many patients – a survey from UK’s University of Wisconsin (UW) points to some 65% of people who are worried about potential postoperative effects. However, a follow-up study by the same university has suggested that major surgery affects little mental capacity in as the years progress.

Data from more than 10,000 British civil service workers, who were subject to cognitive testing over 20 years, highlighted 1,250 people who had major surgery – characterised by a minimum two-night stay at a hospital between their first and last cognitive tests.There were also 715 people admitted for more than two nights for major non-surgical illnesses, including strokes.

The researchers noted that major surgery led to a small decline similar to a little over four months of natural cognitive aging in participants, after accounting for age-related cognitive decline. Surprisingly,non-surgical major hospital admissions were tied to about 1.4 years of aging, and strokes incurred the equivalent of 13 years of aging. Additionally, the risk of substantial cognitive decline for those with major surgical hospital admissions was 2.3 times greater than those without.

Dr. Robert Sanders, an assistant professor at UW, postulates that that anesthesia may affect long-term cognition, but also mentions that this reasoning has not been strongly supported.

Meanwhile, Sandra Weintraub, a professor and clinical core director at the University of Feinberg School of Medicine in Chicago, US, advocates better responsibility among physicians during informed consent – especially in high-risk patients – and suggests cognitive testing prior to surgery.

Weintraub adds, “You don’t know if you are at risk if you’ve never had your memory measured.”

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