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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Statins Increase Risk Of Postoperative Delirium In Elderly Patients, Study Suggests

The use of statins is associated with a 28% increased risk of postoperative delirium in elderly patients, found University of Toronto professor Dr. Donald Redelmeier and colleagues in a retrospective cohort analysis involving more than 280 000 patients.

Ontario's Institute for Clinical Evaluative Sciences (ICES) looked at elderly patients who underwent elective surgery in Ontario and who had received 2 or more prescriptions for statins in the year before surgery, including at least one prescription in the 90 days preceding surgery. Many patients took multiple medications, underwent abdominal, musculoskeletal or urogenital surgery which had a mean duration of about 115 minutes.

Delirium, in addition to causing anxiety in patients and families, contributes to longer hospital stays, a prolonged need for intensive care, and can disrupt and delay care.

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Adding insult to surgical injury

MY WIFE Wendy recently underwent a routine colonoscopy at a teaching hospital in the Boston area. This effective and sometimes lifesaving procedure can locate and remove cancerous polyps in the colon (intestine). But Wendy was unlucky and experienced a medical injury that only occurs in one of 1,000 patients.

And as the hospital staff struggled to deal with the consequences of that injury, my wife and I got a first-hand look at the difficulty healthcare providers have in controlling patients' pain.

During her procedure, the colonoscope - a long, flexible, lighted tube - broke through the wall of her colon, creating a nickel-sized tear in the intestine. The injury could be seen immediately on the monitor. Wendy's doctor explained what had happened, apologized, and rushed her to the operating room for emergency surgery to prevent dangerous internal infections. The two-hour surgery was successful, and left Wendy with a 4-inch abdominal incision.

EWAD MORE @ BOSTON GLOBE