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Long-term Cognitive Trajectory After Total Joint Arthroplasty.

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Area of Science:

  • Orthopedic Surgery
  • Neuroscience
  • Gerontology

Background:

  • Total joint arthroplasty (TJA) involves long-term exposure to metal implants.
  • The association between TJA and long-term cognitive function remains unclear.

Purpose of the Study:

  • To compare cognitive trajectories in individuals with and without TJA.
  • To investigate potential differences in cognitive decline rates based on TJA status.

Main Methods:

  • Population-based cohort study of 5550 participants (≥50 years) from the Mayo Clinic Study of Aging.
  • Assessed serial cognitive evaluations using linear mixed-effects models.
  • Adjusted for age, sex, education, APOE ε4 status, and practice effects.

Main Results:

  • No difference in cognitive decline was observed until age 80.
  • A slightly faster cognitive decline was noted in participants ≥80 years old and >8 years post-surgery (b=-0.03).
  • This faster decline was primarily associated with total knee arthroplasty (TKA) in older individuals (b=-0.04).

Conclusions:

  • Long-term cognitive trajectories are largely similar between TJA and non-TJA groups.
  • A minor, clinically uncertain faster cognitive decline was observed in the oldest TKA patients.
  • Further research is needed to clarify the clinical significance of these findings.