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Obesity and post-operative cognitive dysfunction: a systematic review and meta-analysis

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Item Type:Article
Title:Obesity and post-operative cognitive dysfunction: a systematic review and meta-analysis
Creators Name:Feinkohl, I. and Winterer, G. and Pischon, T.
Abstract:Background: Post-operative cognitive dysfunction (POCD) occurs frequently after surgery, and is related to dementia and premature death. Obesity increases the risk of late-life cognitive impairment, but little is known about its role in POCD. We conducted a systematic review and meta-analysis of studies on the association between obesity and risk of POCD. Methods: PubMed and the Cochrane Library were systematically searched. Studies were included if they had prospective designs, reported on human adults undergoing surgery, if cognitive function was measured pre- and post-surgery, if obesity, body mass index (BMI) and/or body weight were ascertained, and if associations with POCD were reported as relative risks or odds ratios. Underweight, weight loss, and post-operative delirium were not considered. Results: Inclusion criteria were met by six articles. Samples totaled 1432 older patients (mean age ≥62 years) who were followed up for 24 hours to twelve months after surgery. Analysis of studies with obesity defined as a categorical measure found a non-significantly higher risk of POCD among persons with BMI > 30 kg/m2 versus ≤30 kg/m2 (RR 1.27; 95% CI 0.95, 1.70; p = 0.10). No such associations were found for studies that analyzed BMI or body weight continuously as predictors of POCD (RR 0.98 per kg/m2; 95% CI 0.93, 1.03, p = 0.45; RR 0.99 per kg; 95% CI 0.89, 1.09; p = 0.83, respectively). Conclusions: Few studies have addressed the topic, and the results of these studies provide only limited support for an increased risk of POCD in patients who are obese. Further large-scale, prospective investigations are necessary for clarification.
Keywords:Obesity, Body Weight, Adiposity, Post-Operative Cognitive Dysfunction, POCD
Source:Diabetes/Metabolism Research and Reviews
Page Range:643-651
Date:September 2016
Official Publication:https://doi.org/10.1002/dmrr.2786
PubMed:View item in PubMed

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