A large new study suggests that several commonly used medications could help prevent delirium, a sudden and distressing state of confusion, in older adults after surgery.
Delirium affects about one in seven older patients following an operation and can lead to longer hospital stays, slower recovery, and a higher risk of long-term health problems such as dementia.
The research, conducted by scientists at the University of Oxford and published in The BMJ, analyzed data from 158 clinical trials involving more than 41,000 people aged 60 and older.
By combining results from many studies, the researchers were able to compare different drugs and determine which ones were most effective at reducing the risk of delirium.
Delirium often appears as confusion, memory problems, disorientation, or agitation that develops quickly after surgery.
It can be frightening for patients and stressful for families. Older adults are particularly vulnerable because aging brains are more sensitive to the effects of anesthesia, inflammation, pain, and disrupted sleep.
The study found that one medication, dexmedetomidine, showed the most consistent benefit across many types of surgery. This drug is already used as a sedative and pain reliever during operations and in intensive care. Researchers found that it reduced the number of patients who developed delirium after surgery from about 14 out of 100 people to around seven out of 100.
Other medications also showed potential benefits in certain situations, although the evidence was less strong. These included corticosteroids, drugs that regulate sleep cycles, anti-inflammatory pain medications, an antipsychotic medicine, and even intranasal insulin. Scientists say more research is needed before these treatments can be widely recommended.
Interestingly, the type of anesthesia used during surgery did not appear to have a major effect on whether delirium occurred. Preventive medications did not significantly change the length of hospital stays or the risk of death after surgery, but reducing delirium itself could still improve patient comfort and recovery.
Experts say preventing delirium is becoming increasingly important as the population ages and more older adults undergo surgical procedures. Avoiding this complication could help patients regain independence faster, reduce health care costs, and improve overall quality of life.
Researchers are continuing to explore new strategies to protect the brain during and after surgery. One ongoing study is examining whether drugs that reduce inflammation, commonly used to treat conditions like arthritis, might also lower the risk of delirium.
While doctors caution that no single solution will work for everyone, the findings provide encouraging evidence that medications already in use could be repurposed to help vulnerable patients. With further research, these approaches may become part of standard care for older adults facing surgery.
The study highlights the importance of protecting brain health as well as physical recovery, offering hope that future surgical care will be safer and less stressful for older patients and their families.
