Depression and anxiety symptoms are related to pain and frailty but not cognition or delirium in older surgical patients

Wang, Sophia; Cardieri, Brielle; Lin, Hung Mo; Liu, Xiaoyu; Sano, Mary; Deiner, Stacie

doi:10.1002/brb3.2164

Cited by 27 publications

(32 citation statements)

References 36 publications

(38 reference statements)

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“…Furthermore, we used open-field tests to examine the effect of dexmedetomidine treatment on animal behavior, because anxiety and depression are also cognitive symptoms of POCD. [ 34 , 35 ] The data of total distance showed that dexmedetomidine administration did not reduce animal activity; however, surgery significantly reduced the time spent in the center and the bout time in the center ( Figure 7(a) ). Dexmedetomidine abolished this phenomenon, and this effect of dexmedetomidine was reversed by miR-103a-3p inhibitor treatment (Figures 7(b) and 7(c) ).…”

Section: Resultsmentioning

confidence: 99%

Dexmedetomidine Mitigates Microglial Activation Associated with Postoperative Cognitive Dysfunction by Modulating the MicroRNA-103a-3p/VAMP1 Axis

Wang

Shi

et al. 2022

Neural Plasticity

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Surgery-induced microglial activation is critical in mediating postoperative cognitive dysfunction (POCD) in elderly patients, where the important protective effect of dexmedetomidine has been indicated. However, the mechanisms of action of dexmedetomidine during the neuroinflammatory response that underlies POCD remain largely unknown. We found that lipopolysaccharide (LPS) induced substantial inflammatory responses in primary and BV2 microglial cells. The screening of differentially expressed miRNAs revealed that miR-103a-3p was downregulated in these cell culture models. Overexpression of miR-103a-3p mimics and inhibitors suppressed and enhanced the release of inflammatory factors, respectively. VAMP1 expression was upregulated in LPS-treated primary and BV-2 microglial cells, and it was validated as a downstream target of miR-103-3p. VAMP1-knockdown significantly inhibited the LPS-induced inflammatory response. Dexmedetomidine treatment markedly inhibited LPS-induced inflammation and the expression of VAMP1, and miR-103a-3p expression reversed this inhibition. Moreover, dexmedetomidine mitigated microglial activation and the associated inflammatory response in a rat model of surgical trauma that mimicked POCD. In this model, dexmedetomidine reversed miR-103a-3p and VAMP1 expression; this effect was abolished by miR-103a-3p overexpression. Taken together, the data show that miR-103a-3p/VAMP1 is critical for surgery-induced microglial activation of POCD.

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Section: Resultsmentioning

confidence: 99%

Dexmedetomidine Mitigates Microglial Activation Associated with Postoperative Cognitive Dysfunction by Modulating the MicroRNA-103a-3p/VAMP1 Axis

Wang

Shi

et al. 2022

Neural Plasticity

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“…Good surgical effect also helps to improve the anxiety and depression of patients [ 15 ]. A study shows that for patients undergoing elective non cardiac surgery, their preoperative anxiety and depression symptoms are related to their physical weakness [ 16 ]. Another study on cardiac surgery shows that the frailty is related to the perioperative psychological state of patients undergoing cardiac surgery [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Study on anxiety and depression in elderly patients with malignant liver tumor undergoing hepatectomy

et al. 2023

Eur J Med Res

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Background Patients with malignant tumors are more likely to have psychological problems due to their worries about their life expectancy. To understand the psychological status of elderly patients with malignant liver tumor undergoing hepatectomy better, the study was designed to investigate the current situation of anxiety and depression in elderly patients with malignant liver tumor undergoing hepatectomy and to analyze its related factors. Methods A total of 126 elderly patients with malignant liver tumor undergoing hepatectomy were selected as the research objects. The anxiety and depression of all subjects were evaluated by HADS (Hosptial Anxiety and Depression Scale). The correlation factors affecting the psychological state of elderly patients with malignant liver tumor undergoing hepatectomy were analyzed by linear regression method. Results The HADS-A score of elderly patients with malignant liver tumor undergoing hepatectomy was 8.79 ± 2.56, among which 37 patients were asymptomatic, 60 patients with suspicious symptoms, and 29 patients with definite symptoms. The HADS-D score was 8.40 ± 2.97, among which 61 patients were asymptomatic, 39 patients with suspicious symptoms, and 26 patients with definite symptoms. Multivariate analysis using linear regression method showed that FRAIL score, residence, and complication were significantly associated with anxiety and depression of elderly patients with malignant liver tumor undergoing hepatectomy. Conclusions Anxiety and depression in elderly patients with malignant liver tumor undergoing hepatectomy were obvious. FRAIL score, regional differences, and the complication were the risk factors for anxiety and depression in elderly patients with malignant liver tumor undergoing hepatectomy. Improving frailty, reducing regional differences, and preventing complications is beneficial to alleviate the adverse mood of elderly patients with malignant liver tumor undergoing hepatectomy.

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“…Similarly, when Ren et al examined risk factors for postoperative delirium among 263 patients undergoing elective orthopedic surgery, those diagnosed with anxiety were found to be significantly more at risk of postoperative delirium [ 9 ]. Interestingly, in a retrospective analysis of 167 patients, there was no association between preoperative or new‐onset postoperative depression and anxiety symptoms diagnosed using HADS-A and the incidence of postoperative delirium [ 10 ]. This study controlled for those with pre-existing diagnoses of mental disease, and thus Wang et al proposed episodes of preoperative anxiety may increase perceptions of surgical pain and frailty but not cognitive declines [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, in a retrospective analysis of 167 patients, there was no association between preoperative or new‐onset postoperative depression and anxiety symptoms diagnosed using HADS-A and the incidence of postoperative delirium [ 10 ]. This study controlled for those with pre-existing diagnoses of mental disease, and thus Wang et al proposed episodes of preoperative anxiety may increase perceptions of surgical pain and frailty but not cognitive declines [ 10 ]. In a retrospective analysis of 183 patients who underwent temporal lobe surgery for epilepsy, those with anxiety were not found to be at increased risk of postoperative seizure or convulsion reoccurrence but were found to report more auras than matched patients without anxiety [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Anxiety as a Risk Factor for Postoperative Delirium in Elective Spine Deformity Surgeries: A National Database Study

Freedman¹,

Hudock²,

Hallan³

et al. 2022

Cureus

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IntroductionGeneralized anxiety disorder has become one of the most prevalent mental health disorders in the United States. In addition, postoperative delirium has been shown to increase hospital stay, increase mortality, and increased healthcare costs. Few studies have looked at the prevalence of postoperative delirium in patients diagnosed with anxiety undergoing elective spinal deformity procedures. The purpose of this study was to determine if anxiety is a risk factor for postoperative delirium in elective spinal deformity surgeries. MethodsThe authors performed a retrospective analysis using the TriNetX Research Database. Patients diagnosed with kyphosis or lordosis who then underwent elective spinal correction surgeries were identified. This group was then separated based on the diagnosis of a generalized anxiety disorder before the operation versus no diagnosis. Propensity score adjustment, based on mental disorders and other risk factors, was then used to match cohorts on baseline demographics and characteristics. Analysis was performed on the primary outcome of postoperative delirium, with secondary outcomes of upper respiratory tract infections, surgical site infections, sepsis, ventilator dependence, convulsions, stroke, emergency department visits, myocardial infarction, pulmonary embolism, and urinary retention within 30 days after surgery. ResultsOur search included 1,211 patients with a diagnosis of anxiety and 8,055 patients without anxiety. After propensity score matching, 996 patients remained in each cohort. Statistical analysis showed significant outcomes between the matched cohorts in the anxiety group for postoperative delirium (OR 2.788; 1.587-4.899) and convulsions (OR 1.615;. All other outcomes were not significant after propensity score matching. ConclusionThese results showed generalized anxiety disorder is a risk factor for postoperative delirium and convulsions after elective spine surgery. Further research is necessary on the effects of mental health disorders on postoperative delirium and other outcomes to better understand the risks in this population.

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Depression and anxiety symptoms are related to pain and frailty but not cognition or delirium in older surgical patients

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 27 publications

References 36 publications

Dexmedetomidine Mitigates Microglial Activation Associated with Postoperative Cognitive Dysfunction by Modulating the MicroRNA-103a-3p/VAMP1 Axis

Dexmedetomidine Mitigates Microglial Activation Associated with Postoperative Cognitive Dysfunction by Modulating the MicroRNA-103a-3p/VAMP1 Axis

Study on anxiety and depression in elderly patients with malignant liver tumor undergoing hepatectomy

Anxiety as a Risk Factor for Postoperative Delirium in Elective Spine Deformity Surgeries: A National Database Study

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