ArticleThe lancet. Healthy longevity2023
Association of neurocognitive disorders with morbidity and mortality in older adults undergoing major surgery in the USA: a retrospective, population-based, cohort study.
Article in The lancet. Healthy longevity, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 18 citations in OpenAlex.
- Long-Term Cognitive and Functional Outcomes of Anesthesia and Surgery in Patients with Dementia.Healthcare (Basel, Switzerland) · 2026Review
- Glutamate carboxypeptidase II activation in astrocytes mediates glymphatic impairment and cognitive vulnerability in the aging brain following surgery.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Effect of transcranial direct current stimulation on perioperative neurocognitive disorder in elderly patients undergoing abdominal tumour surgery: A randomised controlled trial.European journal of anaesthesiology · 2026Article
- Targeting γ-aminobutyric acid type A receptors to mitigate perioperative neurocognitive disorders: a narrative review.British journal of anaesthesia · 2026Review
- Perioperative neurocognitive disorders: the importance of global systemic interactions.British journal of anaesthesia · 2026Article
- A disease potential-driven graph attention model for comorbidity risk prediction of hypertension.Frontiers in big data · 2026Article
- Gamma Oscillation Disruption Induced By Microglial Activation Contributes to Perioperative Neurocognitive Disorders in Aged Mice.Journal of molecular neuroscience : MN · 2025Article
- Cognitive Trajectory Before and After Cataract Surgery: A Population-Based Approach.Journal of the American Geriatrics Society · 2025Article
- Environmental and capacity drivers of health function: a full perspective of the healthy aging framework.Frontiers in public health · 2025Article
- VR Cognitive-based Intervention for Enhancing Cognitive Functions and Well-being in Older Adults with Mild Cognitive Impairment: Behavioral and EEG Evidence.Psychosocial intervention · 2025Article
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Authors and funding
10 authors at 3 institutions in 1 country.
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Abstract
backgroundNeurocognitive disorders become increasingly common as patients age, and increasing numbers of surgical interventions are done on older patients. The aim of this study was to understand the clinical characteristics and outcomes of surgical patients with neurocognitive disorders in the USA in order to guide future targeted interventions for better care.
methodsThis retrospective cohort study used claims data for US Medicare beneficiaries aged 65 years and older with a record of inpatient admission for a major diagnostic or therapeutic surgical procedure between Jan 1, 2017, and Dec 31, 2018. Data were retrieved through a data use agreement between Dartmouth Hitchcock Medical Center and US Centers for Medicare and Medicaid Services via the Research Data Assistance Center. The exposure of interest was the presence of a pre-existing neurocognitive disorder as defined by diagnostic code within 3 years of index hospital admission. The primary outcome was mortality at 30 days, 90 days, and 365 days from date of surgery among all patients with available data.
findingsAmong 5 263 264 Medicare patients who underwent a major surgical procedure, 767 830 (14·59%) had a pre-existing neurocognitive disorder and 4 495 434 (85·41%) had no pre-existing neurocognitive disorder. Adjusting for demographic factors and comorbidities, patients with a neurocognitive disorder had higher 30-day (hazard ratio 1·24 [95% CI 1·23-1·25]; p<0·0001), 90-day (1·25 [1·24-1·26]; p<0·0001), and 365-day mortality (1·25 [1·25-1·26]; p<0·0001) compared with patients without a neurocognitive disorder.
interpretationOur findings suggest that the presence of a neurocognitive disorder is independently associated with an increased risk of mortality. Identification of a neurocognitive disorder before surgery can help clinicians to better disclose risks and plan for patient care after hospital discharge.
fundingDepartment of Anesthesiology and Perioperative Medicine at Dartmouth Hitchcock Medical Center.
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