Association Between Postoperative Delirium and Long-term Cognitive Function After Major Nonemergent Surgery

Area of Science:

• Neuroscience
• Geriatrics
• Surgical Outcomes

Background:

• Postoperative delirium is linked to cognitive decline in older adults.
• The impact of delirium on cognition in younger, diverse populations remains less understood.

Purpose of the Study:

• To investigate the association between postoperative delirium and long-term cognitive function changes in a younger, heterogeneous patient group.
• To assess if preoperative cognitive status modifies this association.

Main Methods:

• Prospective cohort study including 191 adult patients undergoing major non-emergent surgery.
• Delirium assessed using the Confusion Assessment Method (CAM) within 24-72 hours post-operation.
• Cognitive function measured by the telephone version of the Montreal Cognitive Assessment (T-MoCA) at baseline and 90 days.

Main Results:

• No statistically significant association was found between postoperative delirium and 90-day cognitive change overall.
• Patients with preoperative cognitive impairment showed cognitive improvement at 90 days, but this was attenuated if they experienced delirium.
• After adjusting for preoperative cognitive impairment, patients with delirium showed a slightly greater decrease in T-MoCA scores.

Conclusions:

• Postoperative delirium may not significantly impair long-term cognition in younger adults.
• Preoperative cognitive impairment, while potentially improving post-surgery, is negatively affected by delirium.
• Preoperative cognitive impairment should not be an absolute contraindication for necessary surgical procedures.