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Table of Contents
Vol. 23, No. 6, 2007
Issue release date: May 2007
Dement Geriatr Cogn Disord 2007;23:290–294
(DOI:10.1159/000101453)

Subtle Attentional Deficits in the Absence of Dementia Are Associated with an Increased Risk of Post-Operative Delirium

Lowery D.P. · Wesnes K. · Ballard C.G.
University of Newcastle upon Tyne, Newcastle upon Tyne, UK

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Abstract

Background: Previously, key studies of the risk profile for post-surgical delirium have focused on general medical and non-elective patients, few have examined elective cohorts. Accurate prediction is imperative for clinical trials and prevention strategies. Aims/Hypothesis: Our hypothesis was that subtle pre-operative impairments of attention will be associated with risk of post-operative delirium. Method: A prospective study evaluating pre- and post-operative neuropsychological performance in older (≧70) consecutive elective admissions for orthopaedic surgery, and free of dementia (n = 100) was initiated in a general medical hospital. Results: Pre-operative attentional deficits were closely associated with delirium. Patients who developed post-surgical delirium had significantly slower mean reaction times (p ≤ 0.011) and greater variability of reaction time (p = 0.017). A 4- to 5-fold increased risk of delirium was observed for people one standard deviation above the sample means on these variables. Conclusions: The present study describes a measurement of attentional performance which could form the basis of a neuropsychological marker of delirium.



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