ArticleJournal of the American Geriatrics Society2024
Social determinants of health and incident postoperative delirium: Exploring key relationships in the SAGES study.
Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 15 citations in OpenAlex.
- Association Between ICD-Coded Delirium and Health Determinants in The Atherosclerosis Risk in Communities Study.Journal of the American Geriatrics Society · 2026Article
- Preoperative plasma glial fibrillary acidic protein and postoperative delirium in older adults.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Social Work-Supported Strategies to Reduce Postoperative Readmissions in Orthopedic Surgery: A Narrative Review.Cureus · 2026Review
- Incidence and risk factors for post-stroke delirium in the elderly: A national inpatient sample (NIS) analysis.PloS one · 2026Article
- Brain Microstructural Alteration and Its Implications for Postoperative Delirium in Elderly Surgical Patients: A Narrative Review.Brain and behavior · 2025Review
- Delirium in Elderly Hospitalized Patients: Analyzing Clinical and Social Determinants in a Colombian Retrospective Cohort.International journal of geriatric psychiatry · 2025Article
- Perioperative neurocognitive disorders: a comprehensive review of terminology, clinical implications, and future research directions.Frontiers in neurology · 2025Review
- The Role of Delirium on Short- and Long-Term Postoperative Outcomes Following Major Gastrointestinal Surgery for Cancer.Annals of surgical oncology · 2024Article
- Review
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundExamining the associations of social determinants of health (SDOH) with postoperative delirium in older adults will broaden our understanding of this potentially devastating condition. We explored the association between SDOH factors and incident postoperative delirium.
methodsA retrospective study of a prospective cohort of patients enrolled from June 18, 2010, to August 8, 2013, across two academic medical centers in Boston, Massachusetts. Overall, 560 older adults age ≥70 years undergoing major elective non-cardiac surgery were included in this analysis. Exposure variables included income, lack of private insurance, and neighborhood disadvantage. Our main outcome was incident postoperative delirium, measured using the Confusion Assessment Method long form.
resultsOlder age (odds ratio, OR: 1.01, 95% confidence interval, CI: 1.00, 1.02), income <20,000 a year (OR: 1.12, 95% CI: 1.00, 1.26), lack of private insurance (OR: 1.19, 95% CI: 1.04, 1.38), higher depressive symptomatology (OR: 1.02, 95% CI: 1.01, 1.04), and the Area Deprivation Index (OR: 1.02, 95% CI: 1.01, 1.04) were significantly associated with increased risk of postoperative delirium in bivariable analyses. In a multivariable model, explaining 27% of the variance in postoperative delirium, significant independent variables were older age (OR 1.01, 95% CI 1.00, 1.02), lack of private insurance (OR 1.18, 95% CI 1.02, 1.36), and depressive symptoms (OR 1.02, 95% CI 1.00, 1.03). Household income was no longer a significant independent predictor of delirium in the multivariable model (OR:1.02, 95% CI: 0.90, 1.15). The type of medical insurance significantly mediated the association between household income and incident delirium.
conclusionsLack of private insurance, a social determinant of health reflecting socioeconomic status, emerged as a novel and important independent risk factor for delirium. Future efforts should consider targeting SDOH factors to prevent postoperative delirium in older adults.
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