Cognitive changes in older women after urogynaecological surgery

Brandner, Sonja; Aeberhard, Celine; Mueller, Michael D.; Kühn, Annette

doi:10.5603/gp.a2018.0101

Cited by 4 publications

(4 citation statements)

References 25 publications

(33 reference statements)

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“…However, prior studies have shown that the MMSE has limited ability to detect mild cognitive impairment 25 . In a cohort of patients aged 70 years and older undergoing POP surgery, Brander et al 6 reported a significant increase in cognitive dysfunction using paper‐based Mini‐COG and clock‐drawing tests. Using a paper‐based neurocognitive test battery, Ackenbom et al 7 reported that one‐third of patients undergoing prolapse surgery had significant cognitive dysfunction 2 weeks after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…4 In addition to the risks associated with undergoing surgery at an older age, surgery for POP, in particular, can be of long duration, further increasing the potential risk for cognitive dysfunction. 5 In a group of women with a high rate of baseline cognitive dysfunction (15.7%), Brander et al 6 reported an increased risk of cognitive dysfunction in older women undergoing prolapse and incontinence surgery. Ackenbom et al 7 also reported an increase in postoperative cognitive dysfunction at 2 weeks following urogynecological surgery.…”

Section: Introductionmentioning

confidence: 99%

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Cognitive function following surgery for pelvic organ prolapse

Hassani

Koelper

Borodyanskaya

et al. 2022

Neurourology and Urodynamics

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Introduction and Hypothesis: Older women are at higher risk for cognitive dysfunction following surgery. We hypothesized that for women undergoing pelvic organ prolapse (POP) surgery, memory function would not be significantly different at delayed postoperative assessment compared to baseline. Objective:We sought to compare performance on tests of various neurocognitive domains before and after surgery for POP.Methods: A prospective cohort study was conducted with women, aged 60 years and older who were undergoing surgery for POP. A battery of highly sensitive neurocognitive tests was administered preoperatively (baseline), on postoperative day 1 (postoperative visit 1, POV1), and at the first postoperative clinic visit 4-6 weeks after surgery (postoperative visit 2, POV2). The test battery included the scene-encoding memory task, the n-back task, the Iowa gambling task, the balloon analogue risk task, and the psychomotor vigilance task. These tests assessed the neurocognitive subdomains of episodic memory, working memory, decision-making, risk-taking, and sustained attention. Two score comparisons were made: between baseline and POV1, and between baseline and POV2. Results: In 29 women, performance on the scene-encoding memory task was worse at POV1 than at baseline (2.22 ± 0.4 vs. 2.45 ± 0.6, p < 0.05) but was better than baseline at POV2 (2.7 ± 0.7 vs. 2.45 ± 0.6, p < 0.05). Similarly, performance on the psychomotor vigilance test was worse at POV1 than at baseline (p < 0.01) but there was no difference at POV2. There was no difference in performance on the Iowa gambling test, n-back test, and balloon analogue risk tasks between baseline and any postoperative visit. Conclusion: Cognitive test scores did not worsen significantly between baseline and delayed postoperative assessments in older women undergoing surgery for POP.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cognitive function following surgery for pelvic organ prolapse

Hassani

Koelper

Borodyanskaya

et al. 2022

Neurourology and Urodynamics

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“…In addition to OAB symptoms, hysterectomy may be associated with depression and cognitive symptoms, although studies are still conflicting. Brandner et al, 2018, showed, an overall decline in cognitive function in a vulnerable group of elderly women during the short-term postoperative period [26]. Lewicka et al concluded that women submitted to gynecological surgery were more likely to have depression.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for mild depression in older women with overactive bladder syndrome—A cross sectional study

et al. 2020

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BackgroundStudies demonstrate an association between severe depression and overactive bladder syndrome (OAB). However, mild depression is constantly overlooked. The aim of this study was to evaluate the clinical and sociodemographic factors associated with mild depression in women with OAB. MethodsCross-sectional study involving 241 women over 60 years old in Brasilia, Brazil. All patients were subjected to an interview followed by questionnaires and physical examination. The clinical and sociodemographic variables analyzed were age, body mass index, physical activity level, OAB symptoms, presence of gynecological surgery, fecal incontinence, systemic arterial hypertension, Diabetes Mellitus, anxiety (Beck Anxiety Scale). The Geriatric Depression Scale-15 (GDS-15) was used to identify depression. Univariate logistic regression was used to assess the correlation between mild depression and the variables chosen. Variables with a p-value less than 0.2 were included in the multivariate logistic regression analysis. The level of confidence was set at 95%. Results121 volunteers suffered from mild depression. The multivariate analysis demonstrated that gynecological surgery (p < .001) and anxiety (p < .001) are factors associated with mild depression. Older women with a history of gynecological surgery and a GDS-15 score of 2.04 were 1.08 times more likely to develop mild depression compared to older women with no history of gynecological surgery.

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“…A retrospective analysis of 71 patients aged 46–64 years undergoing elective cardiac surgery revealed that the incidence of postoperative cognitive dysfunction (POCD) could be as high as 33% ( Oyoshi et al, 2023 ). Elderly female patients undergoing non-cardiac surgery of the peripheral system, such as urogynecological surgery including incontinence surgery, vaginal suspension, vaginal hysterectomy, or laparoscopic vaginal sacral fixation, demonstrated an increased incidence of abnormal cognition at 6 weeks postoperatively ( Brandner et al, 2018 ). Total hip arthroplasty or femoral head replacement can significantly increase the incidence of neurocognitive impairment during the awakening period and while in the hospital ( Bhushan et al, 2022 ), and it is noteworthy that anesthetic drug overuse and general anesthesia are frequently avoided based on a cerebral protection standpoint because patients are often elderly, and a Meta-analysis incorporating eight randomized controlled trials (RCTs) including 3,555 patients reported that there was no significant difference in the incidence of POCD after choosing general or regional anesthesia for elderly patients undergoing such procedures, suggesting that severe peripheral injury is the main cause of cognitive impairment ( Bhushan et al, 2022 ).…”

Section: Peripheral Inflammation and Neurocognitive Impairmentmentioning

confidence: 99%

Peripheral inflammation and neurocognitive impairment: correlations, underlying mechanisms, and therapeutic implications

Tan,

Chen,

Kong

et al. 2023

Front. Aging Neurosci.

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Cognitive impairments, such as learning and memory deficits, may occur in susceptible populations including the elderly and patients who are chronically ill or have experienced stressful events, including surgery, infection, and trauma. Accumulating lines of evidence suggested that peripheral inflammation featured by the recruitment of peripheral immune cells and the release of pro-inflammatory cytokines may be activated during aging and these conditions, participating in peripheral immune system-brain communication. Lots of progress has been achieved in deciphering the core bridging mechanism connecting peripheral inflammation and cognitive impairments, which may be helpful in developing early diagnosis, prognosis evaluation, and prevention methods based on peripheral blood circulation system sampling and intervention. In this review, we summarized the evolving evidence on the prevalence of peripheral inflammation-associated neurocognitive impairments and discussed the research advances in the underlying mechanisms. We also highlighted the prevention and treatment strategies against peripheral inflammation-associated cognitive dysfunction.

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Cognitive changes in older women after urogynaecological surgery

Cited by 4 publications

References 25 publications

Cognitive function following surgery for pelvic organ prolapse

Cognitive function following surgery for pelvic organ prolapse

Risk factors for mild depression in older women with overactive bladder syndrome—A cross sectional study

Peripheral inflammation and neurocognitive impairment: correlations, underlying mechanisms, and therapeutic implications

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