Thirumala Parthasarathy D, Snitz Beth E, Jacobsen Erin, Chang Chung-Chou H, Chang Yue-Fang, Ganguli Mary
Departments of Psychiatry.
Neurology.
Alzheimer Dis Assoc Disord. 2025;39(1):39-43. doi: 10.1097/WAD.0000000000000655. Epub 2025 Jan 9.
Postoperative cognitive decline (POCD) is a common, but often unrecognized condition after surgery. We evaluate postsurgical cognitive changes in a longitudinal population-based study.
The study cohort comprises an age-stratified population-based random sample of individuals aged 65+ years from a small-town region of the United States. We identified as cases those participants who, during annual assessments, self-reported having undergone surgery under general anesthesia during the preceding year. We identified as controls those who reported no surgery for at least 6 consecutive years. The outcome variable changed over time (4 y) in annual cognitive test composite scores encompassing the domains of attention/processing speed, executive function, memory, language, and visuospatial functions, which were modeled using Generalized Estimating Equations.
A total of 436 participants had the required cognitive data; 179 participants (cases) had undergone surgery, while 257 participants (controls) had not undergone surgery. After adjusting for age, years of education, gender, race, heart failure, irregular heartbeat, and stroke, participants who underwent surgery had a greater decline in executive function, memory, and attention over a 2-year period.
Participants who underwent surgery had a significant subsequent decline in cognitive function over the long term.
术后认知功能减退（POCD）是手术后常见但常未被识别的一种情况。我们在一项基于人群的纵向研究中评估术后认知变化。
研究队列包括来自美国一个小镇地区65岁及以上人群按年龄分层的基于人群的随机样本。我们将那些在年度评估中自我报告在前一年接受过全身麻醉手术的参与者确定为病例。我们将那些报告至少连续6年未进行手术的人确定为对照。结局变量随时间（4年）在年度认知测试综合评分中发生变化，该评分涵盖注意力/处理速度、执行功能、记忆、语言和视觉空间功能等领域，使用广义估计方程进行建模。
共有436名参与者拥有所需的认知数据；179名参与者（病例）接受了手术，而257名参与者（对照）未接受手术。在调整年龄、受教育年限、性别、种族、心力衰竭、心律失常和中风后，接受手术的参与者在2年期间执行功能、记忆和注意力下降得更多。
接受手术的参与者在长期内认知功能随后出现显著下降。
