Evidence map›Paper›PMID 38190295›Full record

Observational studyJournal of the American Geriatrics Society2024

Long-term cognitive outcome after elective hip or knee total joint arthroplasty: A population-based observational study.

Angelina B Tang, L Grisell Diaz-Ramirez, W John Boscardin, Alexander K Smith, Derek Ward, M Maria Glymour, Elizabeth L Whitlock

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study 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 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.9field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Interplay between orthopedic interventions and dementia: Dementia risk after total knee replacement.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Angelina B TangSchool of Medicine, University of California, San Francisco, San Francisco, California, USA.
L Grisell Diaz-RamirezDivision of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
W John BoscardinDepartment of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California, USA.
Alexander K SmithDivision of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Derek WardDepartment of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA.
M Maria GlymourDepartment of Epidemiology, Boston University, Boston, Massachusetts, USA.
Elizabeth L WhitlockDepartment of Anesthesia & Perioperative Care, University of California, San Francisco, San Francisco, California, USA.ORCID 0000-0002-6868-4301
University of California, San Francisco · USBoston University · US

Funding

VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI REBECCA L SUDORE · 2013 to 2026
$19.9M
Institutional Career Development Core SupplementKL2TR001870 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KANAYA, ALKA M., SARKAR, URMIMALA · 2016 to 2025
$19.7M
Predicting long-term cognitive outcomes and Alzheimer’s disease and related dementias after major noncardiac surgery for older adultsR01AG079263 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Elizabeth Louisa Whitlock · 2022 to 2026
$3.3M
Mentoring Researchers in Prognosis Research in Alzheimer’s Disease and Related DementiasK24AG068312 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Alexander Keliimoeanu Smith · 2020 to 2026
$1.2M
NCATS NIH HHS KL2 TR001870NCATS NIH HHS KL2TR001870NIA NIH HHS K24 AG068312NIA NIH HHS K24AG068312NIA NIH HHS P30 AG044281NIA NIH HHS R01 AG079263NIA NIH HHS R01AG079263
6 · The paper itself

Abstract

backgroundOne year after elective hip or knee total joint arthroplasty (TJA), >30% of older adults meet criteria for postoperative neurocognitive disorder. However, this is not contextualized with long-term cognitive outcomes in comparable surgical and nonsurgical controls. We analyzed population-based data to compare long-term cognitive outcomes in older adults after TJA, other surgeries, and with and without arthritis pain.

methodsThis was a retrospective observational analysis of United States older adults in the Health and Retirement Study (HRS) who underwent elective TJA, or elective surgery without expected functional benefits (e.g., cholecystectomy; inguinal herniorrhaphy), between 1998 and 2018 at aged 65 or older. TJA recipients were also age- and sex-matched to nonsurgical controls who reported moderate-severe arthritic pain or denied pain, so that comparison groups included surgical and nonsurgical (pain-suffering and pain-free) controls. We modeled biennially-assessed memory performance, a measure of direct and proxy cognitive assessments, before and after surgery, normalized to the rate of memory decline ("cognitive aging") in controls to express effect size estimates as excess, or fewer, months of memory decline. We used linear mixed effects models adjusted for preoperative health and demographic factors, including frailty, flexibly capturing time before/after surgery (knots at -4, 0, 8 years; discontinuity at surgery).

resultsThere were 1947 TJA recipients (average age 74; 63% women; 1358 knee, 589 hip) and 1631 surgical controls (average age 76; 38% women). Memory decline 3 years after TJA was similar to surgical controls (5.2 [95% confidence interval, CI -1.2 to 11.5] months less memory decline in the TJA group, p = 0.11) and nonsurgical controls. At 5 years, TJA recipients experienced 5.0 [95% CI -0.9 to 10.9] months less memory decline than arthritic pain nonsurgical controls.

conclusionThere is no systematic accelerated memory decline at 3 years after TJA compared with surgical or nonsurgical controls.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeElective Surgical ProceduresAgedAged, 80 and overCognitionFemaleHumansMaleRetrospective StudiesUnited Statesarthroplastymemorypostoperative neurocognitive disorder

Identifiers

PMID38190295
PMCPMC11090741
OpenAlexW4390674954

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.