Surgery, Illness Not Linked to Mental Decline in Seniors New findings contradict previous reports of increased risks of dementia

Illness and surgery don't contribute to long-term cognitive decline in seniors and don't accelerate progression of dementia, researchers say.

The findings of a new study, published in the November issue of Anesthesiology, challenge the widely held belief that elderly patients suffer major deterioration in mental function after surgery.

"The concerns surrounding postoperative cognitive decline (POCD) following surgery certainly will not evaporate following publication of this study," researcher Michael S. Avidan, of the Washington University School of Medicine, said in a news release from the American Society of Anesthesiologists. "The important message to take from these findings is that persistent cognitive deterioration following surgery might not be a major public health problem. The decision to proceed with surgery should presently be made based on a person's general health and the specific risks and benefits of the procedure."

For the study, Avidan and colleagues looked at 575 patients tested annually at Washington University's Alzheimer Disease Research Center. At the start of the study, 361 patients had very mild or mild dementia and 214 were dementia-free. The patients were divided into three groups -- those who'd undergone non-cardiac surgery, those with illness, and those with neither.

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Confronting Sadness in Seniors

A bit of sadness is a common companion of aging. Over time, after all, seniors may lose vigor, independence, and even loved ones. But when melancholy becomes outright depression, the elderly are at risk of diabetes, heart disease, and even suicide. It's often up to their unofficial caretakers—their children—to spot depression's signs and take steps to address it.

Depression often manifests differently in the elderly than in younger people. Rather than expressing feelings of sadness, depressed seniors may describe physical complaints—increased aches and pains, headaches, weakness, and, commonly, trouble sleeping. "Look for changes in levels of interest, too," says Dan Blazer, professor of psychiatry and behavioral sciences at Duke University Medical Center. Increases in anxiety, irritability, withdrawal, and a decrease in attention to appearance are also common signs. Sometimes, depression arises because of a physical health problem, says Gary Moak, president of the American Association for Geriatric Psychiatry and a professor at the University of Massachusetts Medical School. For example, he says, "as many as 40 percent of stroke victims will develop depression, because many [strokes] occur in an area of the brain that's closely related to the processing and management of emotions." Overall, about 1 in 5 people age 65 and older has depression, according to Moak. The vast majority don't receive the professional treatment they need.

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