Association of apolipoprotein ε4 with postoperative cognitive dysfunction and long-term memory in elderly patients undergoing general anesthesia

2016 ◽  
Author(s):  
Livia Valentin
Keyword(s):  
Elderly Patients ◽  
General Anesthesia ◽  
Cognitive Dysfunction ◽  
Postoperative Cognitive Dysfunction ◽  
Long Term Memory ◽  
Term Memory

Case Studies of Postoperative Cognitive Dysfunction in Elderly Patients

2021 ◽  
pp. 1-5
Author(s):  
Kalliopi Megari ◽  
Kalliopi Megari
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Cognitive Dysfunction ◽  
Critical Role ◽  
Postoperative Cognitive Dysfunction ◽  
Verbal Working Memory ◽  
Short Term

Background and Objective: Postoperative cognitive dysfunction (POCD) involves decline in several cognitive domains after surgery and is particularly common after cardiac surgery. Given the potential effects of such cognitive dysfunction on quality of life, it is important to study it in multiple populations in order to limit its occurrence. Recent advances in surgical technology may assist in achieving this goal. Methods: We present the long-term neuropsychological outcome of two elderly patients, one of whom had off pump heart surgery and the other oncological surgery. We administered a series of neuropsychological tests assessing attention, complex scanning, verbal working memory, executive functioning, short-term and long-term memory, and visuospatial perception before surgery, prior to discharge, at 3-month follow-up and 6 years after surgery. We compared the performance of these two patients to normative datasets. Results: Despite equivalent levels of pre-surgery performance between the two patients, the oncology patient exceeded his preoperative neurocognitive levels, suggesting less postoperative cognitive dysfunction in the heart patient overall, on all neuropsychological domains at 6-year follow-up, except short-term retention. In contrast, the heart patient showed no improvement, and, instead, showed some cognitive decline which remained consistent over time. Conclusion: Our findings highlight the critical role of the type of surgery utilized in the development of POCD and have implications for clinical management and patients’ quality of life in the very long term.

Postoperative Cognitive Dysfunction

2021 ◽  
Vol 1 (3) ◽  
pp. 41-43
Author(s):  
Awang Budi Saksono
Keyword(s):  
Cognitive Impairment ◽  
General Anesthesia ◽  
Cognitive Dysfunction ◽  
Large Body ◽  
Postoperative Cognitive Dysfunction ◽  
Anesthetic Agents ◽  
Incident Dementia ◽  
Anesthetic Considerations ◽  
The Impact

The impact of general anesthesia on cognitive impairment is controversial and complex. A large body of evidence supports the association between exposure to surgery under general anesthesia and the development of delayed neurocognitive recovery in a subset of patients. Existing literature continues to debate whether these short-term effects on cognition can be attributed to anesthetic agents themselves or whether other variables are causative of the observed changes in understanding. Furthermore, there are conflicting data on the relationship between anesthesia exposure and the development of long-term neurocognitive disorders or incident dementia in the patient population with normal preoperative cognitive function. Patients with pre-existing cognitive impairment present a unique set of anesthetic considerations, including potential medication interactions, challenges with cooperation during assessment and non-general anesthesia techniques, and the possibility that pre-existing cognitive impairment may impart a susceptibility to further cognitive dysfunction.

scholarly journals Association of Olfactory Impairment and Postoperative Cognitive Dysfunction in Elderly Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Yang Lan ◽  
Zhi-jian You ◽  
Ruiming Du ◽  
Le-si Chen ◽  
Jia-xuan Wu
Keyword(s):  
Cognitive Function ◽  
Abdominal Surgery ◽  
Elderly Patients ◽  
General Anesthesia ◽  
Cognitive Dysfunction ◽  
Short Term Memory ◽  
Short Term ◽  
Term Memory ◽  
Olfactory Impairment ◽  
Surgical Group

ObjectiveTo investigate the impact of anesthesia on the change of olfactory function and cognitive function in elderly patients who undergo abdominal surgery.MethodsA total of 30 elderly patients who underwent abdominal surgery were recruited as the research subjects. The Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test was used to test the olfactory function and the Mini-mental State Examination (MMSE), Hopkins Verbal Learning Test – Revised (HVLT-R), Trail Making Test (TMT), Stroop Color Word Test (SCWT), Digit-Symbol Coding Test (DSCT), and Verbal Fluency Test (VFT) were used to assess their cognitive function before general anesthesia, and on the 3rd and 7th day post-anesthesia. The serum level of IL-1β, IL-6, and TNF-α were measured before anesthesia and at 0, 12, and 24 h post-anesthesia. In total, 30 healthy volunteers who did not undergo anesthesia were used as the control group. The test results of all subjects were recorded and their correlations were analyzed.ResultsOn the 3rd and 7th day post-anesthesia, the olfactory recognition threshold of patients in the surgical group was lower than that of control group with significant difference (P < 0.05). On the 3rd and 7th postoperative day, the patient’s short-term memory and delayed memory, attention and processing speed were decreased (P < 0.05). On the 7th day post-anesthesia, delayed memory and processing ability were still decreased (P < 0.05). In the surgical group, Spearman correlation analysis showed that the difference of olfactory recognition score on the 3rd and 7th day post-anesthesia was positively correlated with short-term memory and delayed memory of cognitive function. Compared with pre-anesthesia, the serum levels of IL-1β, IL-6, and TNF-α in the surgical group were significantly increased at each time point after anesthesia.ConclusionAbdominal surgery with general anesthesia in elderly patients may increase the level of serum inflammatory factors, induce olfactory impairment, particularly the decline of olfactory identification threshold and cause cognitive dysfunction with declined short-term memory, delayed memory and attention. There was a positive correlation between olfactory impairment and cognitive dysfunction after general anesthesia. Therefore, olfactory impairment could be an early indicator to guide early intervention for postoperative cognitive dysfunction.

P6250Mentalplus digital game usefulness in cognitive dysfunction evaluation compared to neuropsychological testing batteries in a hypertensive treated population

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
V Pereira ◽  
L Valentin
Keyword(s):  
Cognitive Dysfunction ◽  
Inhibitory Control ◽  
Short Term Memory ◽  
Long Term Memory ◽  
Digital Game ◽  
Short Term ◽  
Term Memory ◽  
Significance Level ◽  
Spearman Test

Abstract Introduction Cognitive dysfunction has been a time-consuming evaluation when full neuropsychology battery is performed, what is the most used method up to nowadays. The time is a limitation besides the necessity of a specific professional to apply it. Both reasons limit the clinical use and even research widespread of cognitive dysfunction evaluation in a variety of diseases that we suppose that might be linked to cognitive dysfunction in its lifetime evolution. Purpose The purpose of this study is to evaluate the correlation between a digital game named Mentalplus and a usual neuropsychology battery to cognitive dysfunction evaluation in a hypertensive medically treated and followed group. Methods A 163 hypertensive and followed by cardiologists group was evaluated for cognitive dysfunction by two means: A standard neuropsychology battery that spent around two hours and was performed by neuropsychologists. Then, Mentalplus digital game was applied, for 25 minutes. The Mentalplus digital game was developed to evaluate some cognitive functions like selective and alternate attention, short and long term memory, inhibitory control, language, visuoconstruction, executive function. Spearman test was used to calculate the correlations between specific validated tests with each Mentalplus phase. Staticisticists used IBM-SPSS. The significance level was 5%. Results 41.7% male, mean age of 51.1±16.2 SD years, mean arterial pressure of 93.1±8.7 SD mmHg in use of up to 3 blood pressure medications. Concerning to cognitive evaluation by both methods, the main findings were strong correlations related to functions below: short term memory, comparing VLT-A-1 and Mentalplus phase developed to evaluate that function: (r=0.563, p<0.005); Long term memory, comparing Rey-figure-long term memory and Mentalplus (r=0.887, p<0.005); Attention and Visuoconstruction, comparing Rey-figure copy and Mentalplus: (r=0.929, p<0.005) and Stroop-C and Mentalplus: (r=0.941, p<0.005); Selective attention, comparing TMT-A and Mentalplus phase: (r=0.889, p<0.005); Alternate attention, comparing STOOP-B and TMT-B and Mentalplus phase is similar (r=0>0.98, p<0.005); Inhibitory control, comparing Rey-Figure immediate memory and Mentalplus phase (r=0.969, p<0.005). MentalPlus Short Term Memory - Part I Conclusion Mentalplus phases present a strong correlation with specific validated neuropsychologic tests usually performed in a normal evaluation battery. It opens a useful way to evaluate the cognitive function in a hypertensive treated group during the lifelong time, to follow cognitive dysfunction during treatment with less time consuming and more convenience for the patients. Acknowledgement/Funding FAPESP

scholarly journals Postoperative Cognitive Dysfunction

2021 ◽  
Vol 1 (3) ◽  
pp. 41-43
Author(s):  
Awang Budi Saksono
Keyword(s):  
Cognitive Impairment ◽  
General Anesthesia ◽  
Cognitive Dysfunction ◽  
Large Body ◽  
Postoperative Cognitive Dysfunction ◽  
Anesthetic Agents ◽  
Incident Dementia ◽  
Anesthetic Considerations ◽  
The Impact

The impact of general anesthesia on cognitive impairment is controversial and complex. A large body of evidence supports the association between exposure to surgery under general anesthesia and the development of delayed neurocognitive recovery in a subset of patients. Existing literature continues to debate whether these short-term effects on cognition can be attributed to anesthetic agents themselves or whether other variables are causative of the observed changes in understanding. Furthermore, there are conflicting data on the relationship between anesthesia exposure and the development of long-term neurocognitive disorders or incident dementia in the patient population with normal preoperative cognitive function. Patients with pre-existing cognitive impairment present a unique set of anesthetic considerations, including potential medication interactions, challenges with cooperation during assessment and non-general anesthesia techniques, and the possibility that pre-existing cognitive impairment may impart a susceptibility to further cognitive dysfunction.

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