Cognitive Deficits in Executive and Language Functions Predict Postoperative Delirium

Area of Science:

• Geriatric Medicine
• Neuroscience
• Anesthesiology

Background:

• Postoperative delirium (POD) is a common complication in older adults undergoing surgery.
• Cognitive impairment, especially mild cognitive impairment, is a significant risk factor for POD.
• Preoperative identification of at-risk patients is crucial for targeted delirium prevention strategies.

Purpose of the Study:

• To identify specific cognitive domains that predict the development of POD in older adults.
• To enhance the sensitivity of preoperative cognitive testing for POD risk assessment.
• To guide the application of preventive measures in the perioperative period.

Main Methods:

• Secondary analysis of a randomized controlled trial involving patients aged 60 years and older.
• Preoperative neuropsychological testing and delirium screening were conducted.
• Multiple logistic regression was used to determine the predictive value of cognitive tests for POD.

Main Results:

• The study included 541 patients, with a POD incidence of 15.6%.
• Impaired performance on the Trail Making Test B/A and letter fluency significantly predicted POD risk.
• The logistic regression model demonstrated good discriminative ability (AUC = 0.786).

Conclusions:

• Executive function and language skills, including memory, inhibition, and processing speed, are strongly associated with POD development.
• These findings highlight the importance of assessing specific cognitive domains preoperatively.
• Targeted interventions based on these cognitive predictors can improve POD prevention in older surgical patients.