The question of preoperative anxiety and depression in older patients and family protectors

Abstract

Background: Higher levels of anxiety increase the risks of surgery, including morbidity and mortality. The objectives of this study were to measure anxiety and depression during the preoperative period and to identify the degree of knowledge and concerns of older patients and their family protectors regarding anesthesia, and the causes of these concerns. Methods: We administered a questionnaire to older patients scheduled to undergo surgery and their family protectors one day prior to the surgery. The questionnaire included tools for quantifying anxiety and depression (Anxiety-Visual Analogue Scale, the Amsterdam Preoperative Anxiety and Information Scale, State-Trait Anxiety Inventory Korean YZ Form, and Short Form Geriatric Depression Scale). We also asked about the concrete causes of anxiety using pre-created forms.Results: There were 140 older patients and family protectors who participated in the study. The majority of older patients (n = 114, 81.4%) undergoing surgery and their family protectors (n = 114, 81.4%) indicated that they were anxious. Most of the older patients and their family protectors responded that they had insufficient knowledge about anesthesia, and they were mostly worried about failure to awaken following surgery, and postoperative pain. Older patients with higher anxiety scores showed higher depression scores. There were significant differences in depression scores depending on the presence of cohabitating family members. Conclusions: It is important to remember that older patients with higher depression scores have higher anxiety during the preoperative period.

Preoperative Anxiety in Chinese Adult Patients Undergoing Elective Surgeries: A Multicenter Cross‐Sectional Study

“…The results showed that the overall prevalence of preoperative anxiety in Chinese adult patients undergoing elective surgery was 15.8%. Compared with previously reported rates of 11 to 89% [ 3 , 14 , 21 , 22 ], the prevalence of preoperative anxiety in this study was lower than those from previous domestic [ 21 ] and overseas studies.…”

The overlooked problem among surgical patients: Preoperative anxiety at Ethiopian University Hospital

“…Similarly, previous studies have reported high prevalence of preoperative anxiety in elderly patients ( 37 , 38 ). This association might be explained by comorbidities and frailty that could compromised the elderly’s physiologic reserves to cope with anesthesia and surgery ( 39 , 40 ). In contrast, multiple studies have concluded that preoperative anxiety was more common among young patients ( 16 , 22 , 26 , 31 , 41 – 43 ).…”

Comparison of the effects of cranial electrotherapy stimulation and midazolam as preoperative treatment in geriatric patients: A CONSORT-compliant randomized controlled trial

“…Excessive anxiety activates the sympathetic nervous system and increases the level of corticosteroid, thereby causing hemodynamic instability. [ 20 ] Preoperative anxiety increases postoperative pain, demand for painkillers, and postoperative complications, along with morbidity and mortality. Geriatric patients may be more susceptible to these physiological responses.…”

“…[ 21 ] The homeostatic balance of aged patients is easily disturbed by exogenous stimuli. [ 20 , 22 ]…”