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Relationship Between Depression/Anxiety and Cognitive Function Before and 6 Weeks After Major Non-Cardiac Surgery in Older Adults
Journal of Geriatric Psychiatry and Neurology ( IF 2.6 ) Pub Date : 2020-12-30 , DOI: 10.1177/0891988720978791
Deborah M Oyeyemi 1, 2 , Mary Cooter 1 , Stacey Chung 1 , Heather E Whitson 2, 3 , Jeffrey N Browndyke 4, 5 , Michael J Devinney 1 , Patrick J Smith 4 , Grant E Garrigues 6 , Eugene Moretti 1 , Judd W Moul 7 , Harvey Jay Cohen 2, 3 , Joseph P Mathew 1 , Miles Berger 1, 3, 5 ,
Affiliation  

Objective:

To determine the relationship between affective measures and cognition before and after non-cardiac surgery in older adults.

Methods:

Observational prospective cohort study in 103 surgical patients age ≥ 60 years old. All participants underwent cognitive testing, Center for Epidemiologic Studies-Depression, and State Anxiety Inventory screening before and 6 weeks after surgery. Cognitive test scores were combined by factor analysis into 4 cognitive domains, whose mean was defined as the continuous cognitive index (CCI). Postoperative global cognitive change was defined by CCI change from before to after surgery, with negative CCI change indicating worsened postoperative global cognition and vice versa.

Results:

Lower global cognition before surgery was associated with greater baseline depression severity (Spearman’s r = −0.30, p = 0.002) and baseline anxiety severity (Spearman’s r = −0.25, p = 0.010), and these associations were similar following surgery (r = −0.36, p < 0.001; r = −0.26, p = 0.008, respectively). Neither baseline depression or anxiety severity, nor postoperative changes in depression or anxiety severity, were associated with pre- to postoperative global cognitive change.

Conclusions:

Greater depression and anxiety severity were each associated with poorer cognitive performance both before and after surgery in older adults. Yet, neither baseline depression or anxiety symptoms, nor postoperative change in these symptoms, were associated with postoperative cognitive change.



中文翻译:

老年人主要非心脏手术前后6周抑郁/焦虑与认知功能的关系

客观的:

确定老年人非心脏手术前后情感测量与认知之间的关系。

方法:

对 103 名年龄≥60 岁的手术患者进行的观察性前瞻性队列研究所有参与者在手术前和手术后 6 周都接受了认知测试、流行病学研究中心 - 抑郁症和状态焦虑量表筛查。通过因素分析将认知测试分数合并为4个认知域,其平均值定义为连续认知指数(CCI)。术后整体认知变化由手术前后的 CCI 变化定义,负 CCI 变化表示术后整体认知恶化,反之亦然。

结果:

手术前较低的整体认知与较高的基线抑郁严重程度(Spearman's r = -0.30,p = 0.002)和基线焦虑严重程度(Spearman's r = -0.25,p = 0.010)相关,并且这些关联在手术后相似(r = - 0.36,p < 0.001;r = -0.26,p = 0.008)。无论是基线抑郁或焦虑严重程度,还是术后抑郁或焦虑严重程度的变化,都与手术前后的整体认知变化无关。

结论:

更大的抑郁和焦虑严重程度都与老年人手术前后较差的认知表现有关。然而,无论是基线抑郁或焦虑症状,还是这些症状的术后变化,都与术后认知变化无关。

更新日期:2020-12-31
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