The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin 2, Ireland.
Mercer's Institute for Successful Ageing, Department of Medical Gerontology, St. James's Hospital, Dublin 8, Ireland.
Age Ageing. 2018 May 1;47(3):408-415. doi: 10.1093/ageing/afy020.
the dramatic shift in the global population demographic has led to increasing numbers of older people undergoing hospitalisation and surgical procedures.
to determine whether hospitalisation or hospitalisation with surgery under general anaesthesia is associated with poorer cognitive performance in adults over the age of 50.
cognitive function in the domains of global cognition, memory and executive function was assessed in 8,023 individuals at waves 1 and 2 of The Irish Longitudinal Study on Ageing (TILDA), 2 years apart. Mixed-effects models were used to investigate the hypothesis after adjustment for risk factors for cognitive decline and potential confounders.
during the 12 months preceding wave 1, 472 participants were hospitalised (mean age 67.0, 54.9% female) and a further 560 participants (mean age 64.6, 52.1% female) were hospitalised and underwent surgery with general anaesthesia; 6,938 (mean age 63.5, 54.5% female) were not hospitalised. There was a 14% higher error rate (IRR[95% CI] = 1.14[1.06, 1.22]) in the MMSE in the hospitalisation group and a 6% higher error rate (IRR[95% CI] = 1.06[0.99, 1.13]) in the surgery group compared to those with no hospitalisation. Poorer cognitive performance in the memory tasks was evident in both hospitalisation and hospitalisation with surgery groups (immediate recall: [95% CI] = -0.13 words[-0.22,-0.04] versus -0.13 words[-0.21,-0.04] and delayed recall: -0.20 words[-0.33,-0.06] versus -0.20[-0.32, -0.07]) compared to those with no hospitalisation. Increased error in the time-based prospective memory task was observed in the hospitalisation group and the surgery group (OR[95% CI] = 1.32[1.08, 1.60] versus 1.29[1.07, 1.55]).
hospitalisation and hospitalisation with surgery and general anaesthesia are associated with poorer global and domain specific cognitive performance.
全球人口结构的巨大转变导致越来越多的老年人住院和接受外科手术。
确定住院或全身麻醉下住院手术是否与 50 岁以上成年人的认知功能下降有关。
在爱尔兰老龄化纵向研究（TILDA）的第 1 波和第 2 波中，对 8023 名年龄在 50 岁以上的个体进行了认知功能的评估，包括整体认知、记忆和执行功能等领域。采用混合效应模型，在调整认知能力下降的危险因素和潜在混杂因素后，对假设进行了检验。
在第 1 波前的 12 个月中，472 名患者住院（平均年龄 67.0 岁，54.9%为女性），560 名患者住院并接受全身麻醉手术（平均年龄 64.6 岁，52.1%为女性）；6938 名患者未住院。与未住院的患者相比，住院组的 MMSE 错误率高出 14%（IRR[95%CI] = 1.14[1.06, 1.22]），手术组的错误率高出 6%（IRR[95%CI] = 1.06[0.99, 1.13]）。在记忆任务中，住院组和住院并接受手术组的认知表现均较差（即时回忆：[95%CI] = -0.13 词[-0.22，-0.04]与-0.13 词[-0.21，-0.04]和延迟回忆：-0.20 词[-0.33，-0.06]与-0.20[-0.32，-0.07]）。与未住院的患者相比，住院组和手术组的基于时间的前瞻性记忆任务的错误率增加（OR[95%CI] = 1.32[1.08，1.60]与 1.29[1.07，1.55]）。
住院和全身麻醉下的住院手术与整体和特定领域的认知功能下降有关。
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