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Mental Status Change in Older Surgical Patients

Cognition, Depression, and Other Comorbidity

Received May 8, 1998; revised August 18, November 9, 1998; accepted June 17, 1999. From the Department of Psychiatry, Georgetown University Medical Center, Washington, DC. Address correspondence to Dr. Stockton, Department of Psychiatry, Georgetown University Medical Center, Kober-Cogan 3, 3800 Reservoir Road NW, Washington, DC 20007.

The authors studied patients age 60 and over to assess the effect of elective surgery as a precipitating factor for cognitive decline over the postoperative year. They found an association between change in test performance and age, physical disability, and number of depressive symptoms. However, persistent decline in Mini-Mental State Exam scores was associated with identifiable factors related to the initial surgery in only 3/251 (1 percent of cases). Depression and new onset of acute illness were confounding factors in the assessment of cognitive decline.

Key Words: Delirium • Depression • Anesthesia

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