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Patients who have elective surgery that requires general anesthesia sometimes experience postoperative cognitive dysfunction (POCD). For some time, heart surgery patients have been known to be at risk for POCD–problems with memory, concentration , and processing of information.

Terri Monk, M.D., anesthesiologist Durham Veterans Affairs Medical Center and Duke University, reports in the January 1, 2008, Anesthesiology, that patients over 60-years-old who have elective surgery, such as joint replacements, hysterectomies, and other non-emergency inpatient procedures are at an increased risk for long-term cognitive problems.

Monk’s study included 1,000 adult patients of a range of ages. Additionally, 200 adults were used as a control group. Both groups were given a cognitive test. The participants who had surgery were given the test before they left the hospital following surgery, then again at 3-months following surgery.

Those patients 60-years and older were predisposed to cognitive impairment after major surgery. Patients with a lower educational level and a history of a stroke (without noticeable neurologic impairment) were the most likely to experience POCD.

Education also seemed to be a determinant of postoperative cognitive problems. Those patients with greater education were less likely to be affected with POCD, while those with the lowest level of education were more likely to perform poorly. Patients who were over 60 years of age and performed lowest on the 3 month cognitive test following surgery had a higher frequency of death within the first year. The researchers were at a loss to explain why this occurs.     

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