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Cognitive reserve and the risk of postoperative neurocognitive disorders in older age

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Item Type:Article
Title:Cognitive reserve and the risk of postoperative neurocognitive disorders in older age
Creators Name:Borchers, F. and Rumpel, M. and Laubrock, J. and Spies, C. and Kozma, P. and Slooter, A. and van Montfort, S.J.T. and Piper, S.K. and Wiebach, J. and Winterer, G. and Pischon, T. and Feinkohl, I.
Abstract:BACKGROUND: Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) are postoperative neurocognitive disorders (PNDs) that frequently occur in the aftermath of a surgical intervention. Cognitive reserve (CR) is a concept posited to explain why cognitive health varies between individuals. On this qualitative understanding of cognitive health, factors like IQ, education level, and occupational complexity can affect the impact of neuropathological processes on cognitive outcomes. METHODS: We investigated the association between CR and POD and CR and POCD on data from 713 patients aged≥65 years with elective surgery. Peak pre-morbid IQ was estimated from vocabulary. Occupational complexity was coded according to the Dictionary of Occupational Titles (DOT). Education level was classed according to the International Standard Classification of Education (ISCED). These three factors were used as proxies of CR. In a series of regression models, age, sex, depression, site of surgery, and several lifestyle and vascular factors were controlled for. RESULTS: Patients with a higher IQ had lower odds of developing POD. We found no significant association between the other two CR markers with POD. None of the CR markers was associated with POCD. CONCLUSION: The significant association of a higher IQ with lower POD risk allows for the stratification of elderly surgical patients by risk. This knowledge can aid the prevention and/or early detection of POD. Further research should attempt to determine the lack of associations of CR markers with POCD in our study.
Keywords:Cognitive Reserve, Postoperative Cognitive Dysfunction, Postoperative Neurocognitive Disorders, Postoperative Delirium, Elective Surgery, Geriatric Assessment
Source:Frontiers in Aging Neuroscience
Publisher:Frontiers Media SA
Page Range:1327388
Date:5 February 2024
Official Publication:https://doi.org/10.3389/fnagi.2023.1327388
PubMed:View item in PubMed

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