Clinical Outcomes in Older Surgical Patients with Mild Cognitive Impairment

Overview

Journal Alzheimers Dement

Specialties Neurology
Psychiatry

Date 2017 Dec 1

PMID 29190460

Citations 26

Authors

Annie M Racine

Tamara G Fong

Yun Gou

Thomas G Travison

Douglas Tommet

Kristen Erickson

Richard N Jones

Bradford C Dickerson

Eran Metzger

Edward R Marcantonio

Eva M Schmitt

Sharon K Inouye

Affiliations

Soon will be listed here.

Abstract

Introduction: Older adults, including those with mild cognitive impairment (MCI), are increasingly undergoing surgery.

Methods: Relative risks (RRs) of MCI alone or with delirium on adverse outcomes were estimated in an ongoing prospective, observational cohort study of 560 nondemented adults aged ≥70 years.

Results: MCI (n = 61, 11%) was associated with increased RR of delirium (RR = 1.9, P < .001) and delirium severity (RR = 4.6, P < .001). Delirium alone (n = 107), but not MCI alone (n = 34), was associated with multiple adverse outcomes including more major postoperative complication(s) (RR = 2.5, P = .002) and longer length of stay (RR = 2.2, P < .001). Patients with concurrent MCI and delirium (n = 27) were more often discharged to a postacute facility (RR = 1.4, P < .001) and had synergistically increased risk for new impairments in cognitive functioning (RR = 3.6, P < .001).

Discussion: MCI is associated with increased risk of delirium incidence and severity. Patients with delirium and MCI have synergistically elevated risk of developing new difficulties in cognitively demanding tasks.

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