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Cognitive changes in older women after urogynaecological surgery
Affiliations- Frauenzimmer Bern AG, Bern, Switzerland
- Rheumatology, Departement of Medicine, Inselspital, Switzerland
- Urogynaecology, Department of Gynaecology, Frauenklinik, Inselspital Bern, Switzerland
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Abstract
Objectives: The need for pelvic floor surgery will increase with an aging population in the future. Aim of this prospective
study was to evaluate the evolution of cognitive function in elderly women after urogynaecological surgery.
Material and methods: Between 2010 and 2014, 51 female patients 70 years and older who underwent urogynaecological
surgery participated in this study. Geriatric and urogynaecological assessment were performed before and six weeks after surgery, including the Mini-COG test, the clock-drawing test, a depression scale, an activities of daily living questionnaire, and the German pelvic floor questionnaire.
Results: Mean age was 77 years (range 70–91). Overall, 15 women were operated for incontinence, 31 for prolapse, and
five for miscellaneous reasons. Only two (3.9%) of the 51 women developed postoperative delirium. Abnormal cognitive
findings increased from preoperatively 15.7% to 39.2% six weeks after surgery (odds ratio 3.4, 95% confidence interval
1.3 to 8.7, p < 0.001). There were no statistically significant pre-post differences in activities of daily living and depression scores. Pelvic floor function indices improved significantly
Conclusion: This study shows an overall decline of cognitive function in a vulnerable group of elderly women during the
short-term postoperative period. Postoperative cognitive dysfunction (POCD) after surgery has been described for other
types of non-cardiac surgery but has been understudied in urogynaecological surgery. These patients need interdisciplinary management to prevent or minimize adverse effects of surgery on cognitive function.
Abstract
Objectives: The need for pelvic floor surgery will increase with an aging population in the future. Aim of this prospective
study was to evaluate the evolution of cognitive function in elderly women after urogynaecological surgery.
Material and methods: Between 2010 and 2014, 51 female patients 70 years and older who underwent urogynaecological
surgery participated in this study. Geriatric and urogynaecological assessment were performed before and six weeks after surgery, including the Mini-COG test, the clock-drawing test, a depression scale, an activities of daily living questionnaire, and the German pelvic floor questionnaire.
Results: Mean age was 77 years (range 70–91). Overall, 15 women were operated for incontinence, 31 for prolapse, and
five for miscellaneous reasons. Only two (3.9%) of the 51 women developed postoperative delirium. Abnormal cognitive
findings increased from preoperatively 15.7% to 39.2% six weeks after surgery (odds ratio 3.4, 95% confidence interval
1.3 to 8.7, p < 0.001). There were no statistically significant pre-post differences in activities of daily living and depression scores. Pelvic floor function indices improved significantly
Conclusion: This study shows an overall decline of cognitive function in a vulnerable group of elderly women during the
short-term postoperative period. Postoperative cognitive dysfunction (POCD) after surgery has been described for other
types of non-cardiac surgery but has been understudied in urogynaecological surgery. These patients need interdisciplinary management to prevent or minimize adverse effects of surgery on cognitive function.
Keywords
cognitive function; urogynaecological interventions; pelvic floor function; activities of daily living; dementia; postoperative complications
About this articleTitle
Cognitive changes in older women after urogynaecological surgery
Journal
Issue
Article type
Research paper
Pages
587-592
Published online
2018-11-30
Page views
2028
Article views/downloads
1514
DOI
Pubmed
Bibliographic record
Ginekol Pol 2018;89(11):587-592.
Keywords
cognitive function
urogynaecological interventions
pelvic floor function
activities of daily living
dementia
postoperative complications
Authors
Sonja Brandner
Celine Aeberhard
Michael D. Mueller
Annette Kuhn
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