ArticleBMJ (Clinical research ed.)2019
Association between major surgical admissions and the cognitive trajectory: 19 year follow-up of Whitehall II cohort study.
Article in BMJ (Clinical research ed.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 24 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Perioperative Use of Dexmedetomidine-esketamine Combination and Transcranial Direct Current Stimulation for Prevention of Neurocognitive Complications in Older Patients After Non-cardiac Surgery: a 2×2 Factorial Trial
Long-term Follow-up of Perioperative Dexmedetomidine-esketamine Combination and Transcranial Direct Current Stimulation for Prevention of Neurocognitive Complications in Older Patients After Non-cardiac Surgery
Who cites it
24 citing papers in PubMed.
- Primary Chemoablation of Low-Grade Intermediate-Risk Nonmuscle-Invasive Bladder Cancer Using UGN-102, a Mitomycin-Containing Reverse Thermal Gel (Optima II): A Phase 2b, Open-Label, Single-Arm Trial.The Journal of urology · 2022Trial
- Surgery Is Not Associated With Early Presentation of Alzheimer's Disease and Mild Cognitive Impairment or Increased Risk for Both.CNS neuroscience & therapeutics · 2026Article
- Failure to Re-identify and Manage Known Dementia Associated With Hospital Readmission and LOS: A Retrospective Cohort Study.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- Associations between life satisfaction and hope with cognitive function and decline over 13 years: findings from the Whitehall II study.European journal of ageing · 2025Article
- Anaesthesia as a risk factor for long-term cognitive decline: Results of the prospective MAAS cohort study.European journal of anaesthesiology · 2025Article
- Mechanisms of perioperative neuronal injury and the search for therapies.British journal of anaesthesia · 2025Article
- Association between surgical admissions, cognition, and neurodegeneration in older people: a population-based study from the UK Biobank.The lancet. Healthy longevity · 2024Article
- Association Between Cognitive Trajectories and Subsequent Health Status, Depressive Symptoms, and Mortality Among Older Adults in the United States: Findings From a Nationally Representative Study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- Cognitive and Cerebrospinal Fluid Alzheimer's Disease-related Biomarker Trajectories in Older Surgical Patients and Matched Nonsurgical Controls.Anesthesiology · 2024Article
- Long-term cognitive outcome after elective hip or knee total joint arthroplasty: A population-based observational study.Journal of the American Geriatrics Society · 2024Observational
- Long-term cognitive outcomes after surgery and anesthesia: what we find depends on where we look.Current anesthesiology reports · 2024Article
- Resolution of elevated interleukin-6 after surgery is associated with return of normal cognitive function.British journal of anaesthesia · 2023Article
- The U-shaped curve predicting cognitive vulnerability to delirium severity.Brain : a journal of neurology · 2023Article
- Prospective analysis of plasma amyloid beta and postoperative delirium in the Interventions for Postoperative Delirium: Biomarker-3 study.British journal of anaesthesia · 2023Article
- Perioperative ischaemic brain injury and plasma neurofilament light: a secondary analysis of two prospective cohort studies.British journal of anaesthesia · 2023Article
- Long-term Cognitive Trajectory After Total Joint Arthroplasty.JAMA network open · 2022Article
- Cohort Analysis of the Association of Delirium Severity With Cerebrospinal Fluid Amyloid-Tau-Neurodegeneration Pathologies.The journals of gerontology. Series A, Biological sciences and medical sciences · 2022Observational
- Hospitalisation without delirium is not associated with cognitive decline in a population-based sample of older people-results from a nested, longitudinal cohort study.Age and ageing · 2021Article
- Cerebral Hypoxia: Its Role in Age-Related Chronic and Acute Cognitive Dysfunction.Anesthesia and analgesia · 2021Review
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5 authors.
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Abstract
objectiveTo quantify the association between major surgery and the age related cognitive trajectory.
designProspective longitudinal cohort study.
settingUnited Kingdom.
participants7532 adults with as many as five cognitive assessments between 1997 and 2016 in the Whitehall II study, with linkage to hospital episode statistics. Exposures of interest included any major hospital admission, defined as requiring more than one overnight stay during follow-up. MAIN OUTCOMES MEASURES: The primary outcome was the global cognitive score established from a battery of cognitive tests encompassing reasoning, memory, and phonemic and semantic fluency. Bayesian linear mixed effects models were used to calculate the change in the age related cognitive trajectory after hospital admission. The odds of substantial cognitive decline induced by surgery defined as more than 1.96 standard deviations from a predicted trajectory (based on the first three cognitive waves of data) was also calculated.
resultsAfter accounting for the age related cognitive trajectory, major surgery was associated with a small additional cognitive decline, equivalent on average to less than five months of aging (95% credible interval 0.01 to 0.73 years). In comparison, admissions for medical conditions and stroke were associated with 1.4 (1.0 to 1.8) and 13 (9.6 to 16) years of aging, respectively. Substantial cognitive decline occurred in 2.5% of participants with no admissions, 5.5% of surgical admissions, and 12.7% of medical admissions. Compared with participants with no major hospital admissions, those with surgical or medical events were more likely to have substantial decline from their predicted trajectory (surgical admissions odds ratio 2.3, 95% credible interval 1.4 to 3.9; medical admissions 6.2, 3.4 to 11.0).
conclusionsMajor surgery is associated with a small, long term change in the average cognitive trajectory that is less profound than for major medical admissions. The odds of substantial cognitive decline after surgery was about doubled, though lower than for medical admissions. During informed consent, this information should be weighed against the potential health benefits of surgery.
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