Hippocampal volume reduction in elderly patients at risk for postoperative cognitive dysfunction

Area of Science:

• Neuroscience
• Geriatric Medicine
• Radiology

Background:

• Postoperative cognitive dysfunction (POCD) significantly impacts elderly patients' quality of life, increasing risks of infection and mortality.
• Currently, effective indicators for predicting POCD are lacking.
• The hippocampus, crucial for cognitive function, may offer insights into cognitive changes.

Purpose of the Study:

• To investigate the potential of hippocampal volume, measured by MRI, as a predictor of POCD in elderly patients undergoing major surgery.
• To correlate hippocampal volume with cognitive function test results.

Main Methods:

• Forty-one elderly patients (≥65 years) undergoing open gastrointestinal surgery were included.
• Preoperative MRI measured hippocampal formation volume, standardized by intracranial volume.
• Neuropsychological tests (Wechsler scales, trail making, grooved pegboard) were used to diagnose POCD using Z scores.

Main Results:

• 36% of patients developed POCD post-surgery.
• POCD patients exhibited significantly smaller hippocampal volumes compared to non-POCD patients (4.75 ± 0.23 vs. 5.06 ± 0.31).
• Hippocampal volume showed a significant negative correlation with the composite Z score, indicating its influence on cognitive decline.

Conclusions:

• MRI-based hippocampal volume measurement is a promising predictor for identifying elderly patients at risk of POCD.
• This finding could lead to earlier interventions and improved patient outcomes.