As surgical technologies advance, more older people will be considered candidates for surgery, but this expansion may have unintended consequences.
A University of Sydney led study has revealed multiple surgeries on older patients can have an effect on memory, reaction time, task-switching and problem-solving with each additional surgery.
In this new study, researchers used data from the United Kingdom’s Biobank to analyse half a million people aged 40 to 69 and followed over 20 years of brain scans, cognitive tests and medical records.
These patients underwent procedures, ranging from day surgery to heart bypass operations, with diagnostics and neurosurgery excluded. As part of the study, patients then underwent brain MRIs and cognitive function testing looking for signs of neurodegeneration.
The study found that, with each additional surgery, patients’ overall reaction time slowed by 0⋅3 milliseconds. Cognitive flexibility, problem-solving, and the ability to remember pictures and numbers also decreased with each additional surgery.
“The results suggest that the cognitive decline per surgery may seem small, but those changes and losses in neurodegeneration really start to add up after multiple surgeries,” says lead researcher Dr Jennifer Taylor from the University of Sydney’s Faculty of Medicine and Health.
“We found that surgeries are safe on average but also that the burden of multiple surgeries on the brain health of older patients should not be underestimated,” Dr Taylor added.
This information should be considered when planning surgeries for older adults, particularly those who might undergo multiple operations.
Healthcare providers might also need to consider strategies to protect brain health during and after surgery, such as rehabilitation/enhanced recovery programs, or cognitive ‘prehabilitation’ in elective surgeries. While surgical treatment should not be withheld, it is important to consider ways to optimise cognitive health when considering surgery.
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