Physical and Mental Exercise Lower Chances for Developing Delirium After Surgery

Journal of the American Geriatrics Society Research Summary

After having surgery, many older adults develop delirium, the medical term for sudden and severe confusion. In fact, between 10 and 67 percent of older adults experience delirium after surgery for non-heart-related issues, while 5 to 61 percent experience delirium after orthopedic surgery (surgery dealing with the bones and muscles).

Delirium can lead to problems with thinking and decision-making. It can also make it difficult to be mobile and perform daily functions and can increase the risk for illness and death. Because adults over age 65 undergo more than 18 million surgeries each year, delirium can have a huge impact personally, as well as for families and our communities.

Healthcare providers can use several tools to reduce the chances older adults will develop delirium. Providers can meet with a geriatrician before surgery, review prescribed medications, and make sure glasses and hearing aids are made available after surgery (since difficulty seeing or hearing can contribute to confusion). However, preventing delirium prior to surgery may be the best way to help older adults avoid it.

A team of researchers from Albert Einstein College of Medicine designed a study to see whether older adults who are physically active before having surgery had less delirium after surgery. The research team had previously found that people who enjoy activities such as reading, doing puzzles, or playing games experienced lower rates of delirium. The team published new findings on physical activity in the Journal of the American Geriatrics Society.

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Does Open Heart Surgery Affect Cognitive Abilities?

Journal of the American Geriatrics Society Research Summary

Most people who need open heart surgery to repair damaged heart valves are aged 65 or older. The American Heart Association (AHA) estimates that nearly 8 million people have had heart surgeries. However, we don’t fully understand the effects of heart surgery on an older adult’s cognition (the ability to remember, think, and make decisions).

In 2014, an estimated 156,000 heart valve surgeries were performed in the US. The most common condition for valve surgery was aortic stenosis. The aorta is the heart valve that controls blood flow from your heart to the rest of your body. Aortic stenosis occurs when the aortic valve doesn’t allow blood to flow out of the heart properly. Adults 65 and older represent most of the people who need aortic valve surgery, and the number of older adults with aortic stenosis is expected to double by 2050.

Understanding how heart valve surgery may affect your cognition is important for older adults. To learn more, researchers reviewed studies to see how patients’ cognition changed before and after heart valve surgery. They also looked at whether surgeries on two types of heart valves, the mitral or the aortic, were associated with better or worse outcomes. Their study was published in the Journal of the American Geriatrics Society. Continue reading

Difficulties Diagnosing Delirium in Older Adults After Surgery

JAGS graphicJournal of the American Geriatrics Society Research Summary

Delirium is a medical term for “sudden confusion.” It is an abrupt, rapid change in mental function and can cause a wide variety of shifts in behavior ranging from aggression or agitation to feeling sleepy and inactive (or even a combination of several behaviors). When delirium occurs after an older person has had surgery, it’s called “post-operative delirium.”

Experts still don’t always agree on delirium symptoms or diagnoses, even when they are assessing the same symptoms in the same people. A team of researchers from the Netherlands designed a study to look at the accuracy of delirium diagnoses in older adults after surgeries. Their study was published in the Journal of the American Geriatrics Society.

In the study, researchers examined 167 older adults from one to three days after surgery. The researchers used a standard delirium rating scale and recorded the tests on video. Afterwards, the videos were shown to two independent delirium experts. If the experts didn’t agree on a diagnosis, the researchers asked a third expert to review the video. A third expert was called in for 21 percent of the evaluations. Continue reading