Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Reconstructive Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women's Health (N.K.), University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Neurourol Urodyn. 2022 Nov;41(8):1853-1861. doi: 10.1002/nau.25035. Epub 2022 Sep 1.
Older women are at higher risk for cognitive dysfunction following surgery. We hypothesized that for women undergoing pelvic organ prolapse (POP) surgery, memory function would not be significantly different at delayed postoperative assessment compared to baseline.
We sought to compare performance on tests of various neurocognitive domains before and after surgery for POP.
A prospective cohort study was conducted with women, aged 60 years and older who were undergoing surgery for POP. A battery of highly sensitive neurocognitive tests was administered preoperatively (baseline), on postoperative day 1 (postoperative visit 1, POV1), and at the first postoperative clinic visit 4-6 weeks after surgery (postoperative visit 2, POV2). The test battery included the scene-encoding memory task, the n-back task, the Iowa gambling task, the balloon analogue risk task, and the psychomotor vigilance task. These tests assessed the neurocognitive subdomains of episodic memory, working memory, decision-making, risk-taking, and sustained attention. Two score comparisons were made: between baseline and POV1, and between baseline and POV2.
In 29 women, performance on the scene-encoding memory task was worse at POV1 than at baseline (2.22 ± 0.4 vs. 2.45 ± 0.6, p < 0.05) but was better than baseline at POV2 (2.7 ± 0.7 vs. 2.45 ± 0.6, p < 0.05). Similarly, performance on the psychomotor vigilance test was worse at POV1 than at baseline (p < 0.01) but there was no difference at POV2. There was no difference in performance on the Iowa gambling test, n-back test, and balloon analogue risk tasks between baseline and any postoperative visit.
Cognitive test scores did not worsen significantly between baseline and delayed postoperative assessments in older women undergoing surgery for POP.
老年女性在手术后发生认知功能障碍的风险更高。我们假设对于接受盆腔器官脱垂（POP）手术的女性，与基线相比，延迟术后评估时记忆功能不会有明显差异。
我们旨在比较 POP 手术后不同神经认知领域的测试表现。
对年龄在 60 岁及以上、接受 POP 手术的女性进行前瞻性队列研究。在术前（基线）、术后第 1 天（第 1 次术后就诊，POV1）和术后 4-6 周的第 1 次术后诊所就诊时（第 2 次术后就诊，POV2）进行一系列高度敏感的神经认知测试。测试包括情景编码记忆任务、n 回任务、爱荷华赌博任务、气球模拟风险任务和精神运动警觉任务。这些测试评估了情景记忆、工作记忆、决策、冒险和持续注意力的神经认知子领域。进行了两项评分比较：基线与 POV1 之间的比较，以及基线与 POV2 之间的比较。
在 29 名女性中，与基线相比，情景编码记忆任务在 POV1 的表现更差（2.22±0.4 与 2.45±0.6，p<0.05），但在 POV2 时要好于基线（2.7±0.7 与 2.45±0.6，p<0.05）。同样，在 POV1 时，精神运动警觉测试的表现比基线时更差（p<0.01），但 POV2 时没有差异。在爱荷华赌博测试、n 回测试和气球模拟风险任务中，基线与任何术后就诊时的表现均无差异。
在接受 POP 手术的老年女性中，认知测试评分在基线与延迟术后评估之间没有明显恶化。
