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Cognitive decline after major oncological surgery in the elderly
M Plas1, E Rotteveel2, G J Izaks3
1Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
European Journal of Cancer (Oxford, England : 1990)
|November 4, 2017
Summary
Elderly patients undergoing cancer surgery may experience cognitive decline. Advanced age, lower pre-operative scores, and major surgery increase this risk, necessitating targeted interventions for better quality of life.
Area of Science:
- Geriatric Medicine
- Oncology
- Neuroscience
Background:
- Postoperative cognitive decline is a concern in elderly patients after oncological surgery.
- Identifying risk factors is crucial for managing onco-geriatric patients.
Purpose of the Study:
- To determine the incidence of cognitive decline 3 months post-surgery in elderly cancer patients.
- To identify patient, disease, and surgery-related risk factors for this decline.
Main Methods:
- A cohort of 307 elderly patients (≥65 years) undergoing solid tumor removal was studied.
- Cognitive function was assessed pre-operatively and 3 months post-surgery.
- Decline was defined as a ≥25% score reduction in at least 2 of 5 cognitive tests.
Main Results:
- 53% of patients improved cognitively, while 12% experienced decline at 3 months.
- Higher incidence of decline observed in patients >75 years (18%), with low pre-operative MMSE (37%), and after major surgery (18%).
- Executive function was the most affected cognitive domain.
Conclusions:
- While many elderly patients improve cognitively post-oncological surgery, a significant minority experience decline.
- Advanced age, lower baseline cognitive status (MMSE), and major surgery are key risk factors.
- Focusing research on interventions for high-risk subgroups is essential to preserve quality of life.
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