The short-term and long-term relationship between delirium and cognitive trajectory in older surgical patients
Open accessAbstract
Introduction: As the relationship between delirium and long‐term cognitive decline has not been well‐explored, we evaluated this association in a prospective study. Methods: SAGES is an ongoing study involving 560 adults age 70 years or more without dementia scheduled for major surgery. Delirium was assessed daily in the postoperative period using the Confusion Assessment Method. General Cognitive Performance (GCP) and the Informant Questionnaire for Cognitive Decline in the Elderly were assessed preoperatively then repeatedly out to 36 months. Results: On average, patients with postoperative delirium had significantly lower preoperative cognitive performance, greater immediate (1 month) impairment, equivalent recovery at 2 months, and significantly greater long‐term cognitive decline relative to the nondelirium group. Proxy reports corroborated the clinical significance of the long‐term cognitive decline in delirious patients. Discussion: Cognitive decline after surgery is biphasic and accelerated among persons with delirium. The pace of long‐term decline is similar to that seen with mild cognitive impairment.
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- Authors
- Inouye, S. K., Marcantonio, E. R., Kosar, C. M., Tommet, D., Schmitt, E. M., Travison, T. G., Saczynski, J. S., Ngo, L. H., Alsop, D. C., & Jones, R. N.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- Hebrew SeniorLife (US)
- Brown University (US)
- Northeastern University (US)
- Corresponding author
- Jones, Richard N.
- ORCID
- Venue
- Alzheimer's & Dementia
- Publisher
- Wiley
- Published
- 2016-04-18
- Volume
- 12
- Issue
- 7
- Pages
- 766-775
- ISSN
- 1552-5260 (ISSN-L)
- 1552-5279
- PMC
- PMC4947419
- OpenAlex
- W2340599556
- Cited by
- 462
- References
- 56
- Citations by year
- 2026: 42 · 2025: 37 · 2024: 49 · 2023: 41 · 2022: 65 · 2021: 60 · 2020: 48 · 2019: 46 · 2018: 36 · 2017: 32 · 2016: 6
- FWCI
- 36.28
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Alzheimer s & Dementia (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (acceptedVersion)
- Funders
- National Institute on Aging (P01AG031720, K07AG041835, R01AG044518, R01AG030618, K24AG035075)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Life Sciences › Neuroscience › Developmental Neuroscience › Anesthesia and Neurotoxicity Research
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- postoperative delirium, cognitive decline
- MeSH terms
- Aged, Cognition Disorders, Delirium, Female, Hospitalization, Humans, Longitudinal Studies, Male, Neuropsychological Tests, Postoperative Complications, Prospective Studies, Psychiatric Status Rating Scales, Risk Factors
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