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Occurence and Predictors of Short-Term Mental and Functional Changes in Older Adults Undergoing Elective Surgery Under General Anesthesia

Received July 23, 1996; revised January 12, 1997; accepted April 3, 1997. From the Departments of Psychiatry and Internal Medicine, State University of New York at Buffalo, School of Medicine and Biomedical Sciences. Address correspondence to Dr. Goldstein, Erie County Medical Center, Department of Psychiatry, 462 Grider Street, Buffalo, NY 14215.

The authors studied the cognitive, affective, and functional status of 172 mentally healthy patients, age 55 and older, who were undergoing elective surgery under general anesthesia. Patients were interviewed before and after surgery; this report focuses on changes 1 month postoperatively. Authors compared the mental status and function of 190 nonsurgical patients of comparable age. Surgical patients showed a temporary functional decline. Linear regression predictors of affective, cognitive, and functional change at follow-up included demographics, baseline measures of mental status and function, surgery type, and intraoperative measures. Longer duration of anesthesia—but not type of surgery—predicted short-term decline in activities of daily living but not cognition or affect. Authors discuss results in the context of previous findings in which surgery had no impact on mental status or function at 10-month follow-up.

Key Words: Geriatric • Surgery • Delirium

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