Postsurgical Delirium Linked to Loss of Long-Term Cognitive Function

Delirium is common after cardiac surgery and may be associated with long-term changes in cognitive function, said researchers at the Division of Geriatric Medicine of the University of Massachusetts Medical School in the July 5 New England Journal of Medicine. They enrolled 225 patients aged 60 or older who were planning to undergo coronary-artery bypass grafting or valve replacement. Patients were assessed preoperatively, daily during hospitalization beginning on postoperative day two, and at one, six, and 12 months after surgery. Cognitive function was assessed with  the Mini–Mental State Examination. Delirium was diagnosed with the Confusion Assessment Method. They examined performance on the MMSE in the first year after surgery.

The 103 participants (46 percent) in whom delirium developed postoperatively had lower preoperative mean MMSE scores than those in whom delirium did not develop. Patients with delirium had a larger drop in cognitive function two days after surgery than did those without delirium, and they had significantly lower postoperative cognitive function than those without delirium, both at one month and at one year after surgery. “Delirium is associated with a significant decline in cognitive ability during the first year after cardiac surgery, with a trajectory characterized by an initial decline and prolonged impairment,” the researchers

Read more about causes and treatment of delirium in the Textbook of Geriatric Neuropsychiatry, Third Edition, available from American Psychiatric Publishing, here.

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