Major surgery linked to small, long-term brain function decline

In a new study, researchers found major surgery is linked to a small long-term decline in cognitive functioning.

The decline is equivalent to less than five months of natural brain aging. But the odds of substantial cognitive decline could also increase after surgery, approximately doubling.

The research was conducted by a team from the University of Wisconsin and other institutes.

Cognitive decline is the gradual loss of brain functioning that occurs with aging.

It often starts decades before the conventional definition of old age and accelerates with aging and the presence of increasing many underlying health conditions.

Certain health issues, such as stroke, can lead to a large “step change” in cognitive decline.

There have been concerns that surgery might also do this, with some patients refusing beneficial surgical procedures as a result.

So far, the potential impact of major surgery on the cognitive decline has been unclear.

In the study, the team accessed data on 7,532 British civil servants enrolled in the Whitehall II Study.

All the patients were aged between 35 and 55 in 1985 and received up to five cognitive assessments over a 19-year period (1997 to 2016).

Overall, 8,982 “major” events were identified in these people: 4,525 operations; 4,306 medical admissions; and 151 strokes.

The team found that major surgery was linked to a small cognitive decline of fewer than five months (0.35 years), on average.

Admissions for medical conditions and stroke were linked to a far greater additional cognitive decline of 1.4 and 13 years, respectively.

Hospital admission for major surgery or a medical condition also increased the odds of substantial cognitive decline by 2.3 and 6.2, respectively.

The substantial cognitive decline occurred in 5.5% of patients who spent time in the hospital for a surgical procedure and 12.7% of those treated in hospital for a medical condition.

Overall, the results suggest that major surgery is linked to a small long term decline cognitive function, with the odds of substantial decline doubling.

The team says this study had no information on the type of anesthesia used during surgery, so its potential role in any long-term cognitive change couldn’t be assessed.

They suggest this information should be conveyed to patients and be weighed against the potential health and quality of life benefits of surgery during informed consent.

The study is published in The BMJ.

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