{"id":6047,"date":"2019-01-22T13:33:22","date_gmt":"2019-01-22T18:33:22","guid":{"rendered":"https:\/\/www.med.unc.edu\/aging\/?p=6047"},"modified":"2019-01-22T13:47:35","modified_gmt":"2019-01-22T18:47:35","slug":"post-operative-delirium-leads-to-cognitive-decline-in-all-patients","status":"publish","type":"post","link":"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/","title":{"rendered":"Post-Operative Delirium Leads to Cognitive Decline in All Patients"},"content":{"rendered":"

Pulmonary and Critical Care Physician and Geriatrician Dr. Adrian Austin’s and Division of Geriatric Medicine Chief Dr. Jan Busby-Whitehead\u2019s study on pre-operative cognitive impairment, post-operative delirium, and longterm cognitive function after non-emergent surgery is the lead article<\/a> in a recently published issue of JAMA Surgery.<\/em><\/p>\n

Dr. Austin’s and Busby-Whitehead’s paper presents the results of a large project conducted by the Investigators in Delirium Consortium at UNC (I-DUNC), a working group consisting of researchers and clinicians in Geriatric Medicine, Critical Care Medicine, Pharmacology, Epidemiology, and Nursing. The authors were also interviewed<\/a> about their study.<\/p>\n

Among the study\u2019s key findings are that patients with pre-operative cognitive impairment actually improve after surgery and that post-operative delirium contributes<\/em> to 30-day and 90-day cognitive decline<\/em> among all adults, not just the oldest patients.<\/p>\n

Delirium is a sudden change in mental status that can last days or weeks, complicate recovery, and be enormously stressful for both patients and families. Patients and families should be prepared for the possibility of delirium, which can be frightening for family members without context for what is happening and why their loved one\u2019s mental state is suddenly so altered. Delirium can bring on agitation, confusion, anger, fear, and a range of unpredictable behaviors.<\/p>\n

Pre-operative Cognitive Impairment and Surgery
\n<\/strong>Pre-operative cognitive impairment improving after surgery \u201cseems counter-intuitive, but if you think about it, it makes sense,\u201d says the study\u2019s lead author, Adrian Austin, MD, MCSR.<\/p>\n

\"Dr.
Dr. Adrian Austin, Geriatrician, Pulmonary and Critical Care Physician, and Delirium Researcher<\/figcaption><\/figure>\n

Patients have surgery for a reason, which could be impacting their thinking, memory, and focus. Alleviating this issue, says Austin, can lead to an improvement in cognitive ability. \u201cPre-operative cognitive impairment alone should not preclude patients from having the indicated surgery,\u201d says Austin, \u201cwhich may actually improve cognitive function.\u201d<\/p>\n

Post-operative Delirium and Cognitive Decline
\n<\/strong>The study\u2019s second major finding was, in fact, not surprising: patients who experience delirium after surgery show 30-day and 90-day cognitive decline. \u201cWe need to be cognizant of this and realize that delirium impacts everybody,\u201d says Austin, \u201cnot just older patients.\u201d<\/p>\n

Dr. Busby-Whitehead emphasizes the importance of post-operative measures that can help to minimize delirium such as mobilizing early and ambulating frequently, maintaining good sleep \/ wake cycles, and keeping cognition aids like glasses and hearing aids with the patient.<\/p>\n

\"Dr.
Dr. Jan Busby-Whitehead<\/figcaption><\/figure>\n

Patients Undergoing Surgery Should Be Advised on Potential Delirium
\n<\/strong>Patients and family members benefit when they know what to expect and how best to support their loved ones. Austin and Busby-Whitehead stressed the importance of surgeons preparing patients for the possibility of delirium.<\/p>\n

\u201cDelirium is one of the more common complications after surgery, at least in older adults,\u201d says Busby-Whitehead. \u201cDelirium occurs after 15% of elective noncardiac surgeries and in up to 50% of more high-risk procedures, so it\u2019s wise to let families and patients know there\u2019s a chance that they\u2019ll have delirium after surgery, and that the surgeon and hospital will try to minimize contributing factors.\u201d<\/p><\/blockquote>\n

For surgeons and hospitals, a focus on minimizing delirium aligns well with early recovery protocols that focus on getting people up and moving and keeping a good post-operative sleep \/ wake \u00a0cycle. \u201cThese can seem like trivial issues,\u201d says Austin. \u201cBut they can affect our outcomes, and if we\u2019re not thinking about them, we\u2019re less likely to implement them.\u201d<\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Pulmonary and Critical Care Physician and Geriatrician Dr. Adrian Austin’s and Division of Geriatric Medicine Chief Dr. Jan Busby-Whitehead\u2019s study on pre-operative cognitive impairment, post-operative delirium, and longterm cognitive function after non-emergent surgery is the lead article in a recently published issue of JAMA Surgery. Read more <\/a><\/p>\n","protected":false},"author":31116,"featured_media":6056,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[2],"tags":[49,26,46,48,47],"class_list":["post-6047","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-cognitive-decline-post-surgery","tag-delirium","tag-delirium-research","tag-post-operative-delirium","tag-pre-operative-cognitive-impairment","odd"],"acf":[],"yoast_head":"\nPost-Operative Delirium Leads to Cognitive Decline in All Patients | Center for Aging and Health<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Post-Operative Delirium Leads to Cognitive Decline in All Patients | Center for Aging and Health\" \/>\n<meta property=\"og:description\" content=\"Pulmonary and Critical Care Physician and Geriatrician Dr. Adrian Austin's and Division of Geriatric Medicine Chief Dr. Jan Busby-Whitehead\u2019s study on pre-operative cognitive impairment, post-operative delirium, and longterm cognitive function after non-emergent surgery is the lead article in a recently published issue of JAMA Surgery. Read more\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/\" \/>\n<meta property=\"og:site_name\" content=\"Center for Aging and Health\" \/>\n<meta property=\"article:published_time\" content=\"2019-01-22T18:33:22+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2019-01-22T18:47:35+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.med.unc.edu\/aging\/wp-content\/uploads\/sites\/753\/2019\/01\/Screen-Shot-2019-01-22-at-1.37.21-PM.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1324\" \/>\n\t<meta property=\"og:image:height\" content=\"838\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@UNCGeriatrics\" \/>\n<meta name=\"twitter:site\" content=\"@UNCGeriatrics\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/\"},\"author\":{\"name\":\"\",\"@id\":\"\"},\"headline\":\"Post-Operative Delirium Leads to Cognitive Decline in All Patients\",\"datePublished\":\"2019-01-22T18:33:22+00:00\",\"dateModified\":\"2019-01-22T18:47:35+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/\"},\"wordCount\":583,\"image\":{\"@id\":\"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.med.unc.edu\/aging\/wp-content\/uploads\/sites\/753\/2019\/01\/Screen-Shot-2019-01-22-at-1.37.21-PM.png\",\"keywords\":[\"cognitive decline post-surgery\",\"delirium\",\"delirium research\",\"post-operative delirium\",\"pre-operative cognitive impairment\"],\"articleSection\":[\"News\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/\",\"url\":\"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/\",\"name\":\"Post-Operative Delirium Leads to Cognitive Decline in All Patients | Center for Aging and Health\",\"isPartOf\":{\"@id\":\"https:\/\/www.med.unc.edu\/aging\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.med.unc.edu\/aging\/wp-content\/uploads\/sites\/753\/2019\/01\/Screen-Shot-2019-01-22-at-1.37.21-PM.png\",\"datePublished\":\"2019-01-22T18:33:22+00:00\",\"dateModified\":\"2019-01-22T18:47:35+00:00\",\"author\":{\"@id\":\"\"},\"breadcrumb\":{\"@id\":\"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/#primaryimage\",\"url\":\"https:\/\/www.med.unc.edu\/aging\/wp-content\/uploads\/sites\/753\/2019\/01\/Screen-Shot-2019-01-22-at-1.37.21-PM.png\",\"contentUrl\":\"https:\/\/www.med.unc.edu\/aging\/wp-content\/uploads\/sites\/753\/2019\/01\/Screen-Shot-2019-01-22-at-1.37.21-PM.png\",\"width\":1324,\"height\":838,\"caption\":\"Postoperative delirium and longterm cognitive function study\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.med.unc.edu\/aging\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Post-Operative Delirium Leads to Cognitive Decline in All Patients\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.med.unc.edu\/aging\/#website\",\"url\":\"https:\/\/www.med.unc.edu\/aging\/\",\"name\":\"Center for Aging and Health\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.med.unc.edu\/aging\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"\",\"url\":\"https:\/\/www.med.unc.edu\/aging\/author\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Post-Operative Delirium Leads to Cognitive Decline in All Patients | Center for Aging and Health","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/","og_locale":"en_US","og_type":"article","og_title":"Post-Operative Delirium Leads to Cognitive Decline in All Patients | Center for Aging and Health","og_description":"Pulmonary and Critical Care Physician and Geriatrician Dr. Adrian Austin's and Division of Geriatric Medicine Chief Dr. Jan Busby-Whitehead\u2019s study on pre-operative cognitive impairment, post-operative delirium, and longterm cognitive function after non-emergent surgery is the lead article in a recently published issue of JAMA Surgery. Read more","og_url":"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/","og_site_name":"Center for Aging and Health","article_published_time":"2019-01-22T18:33:22+00:00","article_modified_time":"2019-01-22T18:47:35+00:00","og_image":[{"width":1324,"height":838,"url":"https:\/\/www.med.unc.edu\/aging\/wp-content\/uploads\/sites\/753\/2019\/01\/Screen-Shot-2019-01-22-at-1.37.21-PM.png","type":"image\/png"}],"twitter_card":"summary_large_image","twitter_creator":"@UNCGeriatrics","twitter_site":"@UNCGeriatrics","twitter_misc":{"Written by":"","Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/#article","isPartOf":{"@id":"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/"},"author":{"name":"","@id":""},"headline":"Post-Operative Delirium Leads to Cognitive Decline in All Patients","datePublished":"2019-01-22T18:33:22+00:00","dateModified":"2019-01-22T18:47:35+00:00","mainEntityOfPage":{"@id":"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/"},"wordCount":583,"image":{"@id":"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/#primaryimage"},"thumbnailUrl":"https:\/\/www.med.unc.edu\/aging\/wp-content\/uploads\/sites\/753\/2019\/01\/Screen-Shot-2019-01-22-at-1.37.21-PM.png","keywords":["cognitive decline post-surgery","delirium","delirium research","post-operative delirium","pre-operative cognitive impairment"],"articleSection":["News"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/","url":"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/","name":"Post-Operative Delirium Leads to Cognitive Decline in All Patients | Center for Aging and Health","isPartOf":{"@id":"https:\/\/www.med.unc.edu\/aging\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/#primaryimage"},"image":{"@id":"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/#primaryimage"},"thumbnailUrl":"https:\/\/www.med.unc.edu\/aging\/wp-content\/uploads\/sites\/753\/2019\/01\/Screen-Shot-2019-01-22-at-1.37.21-PM.png","datePublished":"2019-01-22T18:33:22+00:00","dateModified":"2019-01-22T18:47:35+00:00","author":{"@id":""},"breadcrumb":{"@id":"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/#primaryimage","url":"https:\/\/www.med.unc.edu\/aging\/wp-content\/uploads\/sites\/753\/2019\/01\/Screen-Shot-2019-01-22-at-1.37.21-PM.png","contentUrl":"https:\/\/www.med.unc.edu\/aging\/wp-content\/uploads\/sites\/753\/2019\/01\/Screen-Shot-2019-01-22-at-1.37.21-PM.png","width":1324,"height":838,"caption":"Postoperative delirium and longterm cognitive function study"},{"@type":"BreadcrumbList","@id":"https:\/\/www.med.unc.edu\/aging\/post-operative-delirium-leads-to-cognitive-decline-in-all-patients\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.med.unc.edu\/aging\/"},{"@type":"ListItem","position":2,"name":"Post-Operative Delirium Leads to Cognitive Decline in All Patients"}]},{"@type":"WebSite","@id":"https:\/\/www.med.unc.edu\/aging\/#website","url":"https:\/\/www.med.unc.edu\/aging\/","name":"Center for Aging and Health","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.med.unc.edu\/aging\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Person","@id":"","url":"https:\/\/www.med.unc.edu\/aging\/author\/"}]}},"featured_image":"https:\/\/www.med.unc.edu\/aging\/wp-content\/uploads\/sites\/753\/2019\/01\/Screen-Shot-2019-01-22-at-1.37.21-PM.png","featured_image_medium":"https:\/\/www.med.unc.edu\/aging\/wp-content\/uploads\/sites\/753\/2019\/01\/Screen-Shot-2019-01-22-at-1.37.21-PM-300x190.png","featured_image_medium_large":"https:\/\/www.med.unc.edu\/aging\/wp-content\/uploads\/sites\/753\/2019\/01\/Screen-Shot-2019-01-22-at-1.37.21-PM-768x486.png","featured_image_large":"https:\/\/www.med.unc.edu\/aging\/wp-content\/uploads\/sites\/753\/2019\/01\/Screen-Shot-2019-01-22-at-1.37.21-PM-1024x648.png","featured_image_thumbnail":"https:\/\/www.med.unc.edu\/aging\/wp-content\/uploads\/sites\/753\/2019\/01\/Screen-Shot-2019-01-22-at-1.37.21-PM-150x150.png","featured_image_alt":"Postoperative delirium and longterm cognitive function study featured in JAMA Surgery, January 16, 2019.","category_details":[{"name":"News","link":"https:\/\/www.med.unc.edu\/aging\/category\/news\/"}],"tag_details":[{"name":"cognitive decline post-surgery","link":"https:\/\/www.med.unc.edu\/aging\/tag\/cognitive-decline-post-surgery\/"},{"name":"delirium","link":"https:\/\/www.med.unc.edu\/aging\/tag\/delirium\/"},{"name":"delirium research","link":"https:\/\/www.med.unc.edu\/aging\/tag\/delirium-research\/"},{"name":"post-operative delirium","link":"https:\/\/www.med.unc.edu\/aging\/tag\/post-operative-delirium\/"},{"name":"pre-operative cognitive impairment","link":"https:\/\/www.med.unc.edu\/aging\/tag\/pre-operative-cognitive-impairment\/"}],"_links_to":[],"_links_to_target":[],"_links":{"self":[{"href":"https:\/\/www.med.unc.edu\/aging\/wp-json\/wp\/v2\/posts\/6047","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.med.unc.edu\/aging\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.med.unc.edu\/aging\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.med.unc.edu\/aging\/wp-json\/wp\/v2\/users\/31116"}],"replies":[{"embeddable":true,"href":"https:\/\/www.med.unc.edu\/aging\/wp-json\/wp\/v2\/comments?post=6047"}],"version-history":[{"count":0,"href":"https:\/\/www.med.unc.edu\/aging\/wp-json\/wp\/v2\/posts\/6047\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.med.unc.edu\/aging\/wp-json\/wp\/v2\/media\/6056"}],"wp:attachment":[{"href":"https:\/\/www.med.unc.edu\/aging\/wp-json\/wp\/v2\/media?parent=6047"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.med.unc.edu\/aging\/wp-json\/wp\/v2\/categories?post=6047"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.med.unc.edu\/aging\/wp-json\/wp\/v2\/tags?post=6047"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}