Evidence map›Paper›PMID 39245058›Full record

ArticleThe lancet. Healthy longevity2024

Association between surgical admissions, cognition, and neurodegeneration in older people: a population-based study from the UK Biobank.

Jennifer Taylor, Kristy P Robledo, Vicente Medel, Gillian Heller, Thomas Payne, Jordan Wehrman, Cameron Casey, Phillip F Yang, Bryan M Krause, Richard Lennertz and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The lancet. Healthy longevity, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
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

9 citing papers in PubMed.

  1. Article
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  9. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Jennifer TaylorDepartment of Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia; NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia. Electronic address: jennifer.taylor1@sydney.edu.au.
Kristy P RobledoNHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia.
Vicente MedelLatin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile.
Gillian HellerNHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia.
Thomas PayneDepartment of Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia; NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Jordan WehrmanDepartment of Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia; NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Cameron CaseyDepartment of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Phillip F YangSurgical Outcomes Research Centre (SOuRCe), Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; South West Sydney Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
Bryan M KrauseDepartment of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Richard LennertzDepartment of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Sharon NaismithHealthy Brain Ageing Program, Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.
Armando Teixeira-PintoSchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Robert D SandersDepartment of Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia; NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.

Funding

Clarifying the overlapping pathology of delirium and dementiaR01AG063849 · NIA · UNIVERSITY OF WISCONSIN-MADISON · PI Richard C Lennertz, Robert D Sanders · 2019 to 2026
$5.0M
Perinatal Stroke: Longitudinal Assessment of Infant Brain Organization and Recovery through Neuroexcitability, Neuroimaging and Motor DevelopmentR01HD098202 · NICHD · UNIVERSITY OF WISCONSIN-MADISON · PI GILLICK, BERNADETTE THERESE · 2020 to 2025
$2.9M
Receptors, microcircuits and hierarchical connectivity in predictive coding and sensory awarenessR01NS117901 · NINDS · UNIVERSITY OF WISCONSIN-MADISON · PI SAALMANN, YURI B · 2020 to 2024
$2.1M
NIA NIH HHS R01 AG063849NICHD NIH HHS R01 HD098202NINDS NIH HHS R01 NS117901
6 · The paper itself

Abstract

backgroundPrevious studies have shown that major surgical and medical hospital admissions are associated with cognitive decline in older people (aged 40-69 years at recruitment), which is concerning for patients and caregivers. We aimed to validate these findings in a large cohort and investigate associations with neurodegeneration using MRI.

methodsFor this population-based study, we analysed data from the UK Biobank collected from March 13, 2006, to July 16, 2023, linked to the National Health Service Hospital Episode Statistics database, excluding participants with dementia diagnoses. We constructed fully adjusted models that included age, time, sex, Lancet Commission dementia risk factors, stroke, and hospital admissions with a participant random effect. Primary outcomes were hippocampal volume and white matter hyperintensities, both of which are established markers of neurodegeneration, and exploratory analyses investigated the cortical thickness of Desikan-Killiany-Tourville atlas regions. The main cognitive outcomes were reaction time, fluid intelligence, and prospective and numeric memory. Surgeries were calculated cumulatively starting from 8 years before the baseline evaluation.

findingsOf 502 412 participants in the UK Biobank study, 492 802 participants were eligible for inclusion in this study, of whom 46 706 underwent MRI. Small adverse associations with cognition were found per surgery: reaction time increased by 0·273 ms, fluid intelligence score decreased by 0·057 correct responses, prospective memory (scored as correct at first attempt) decreased (odds ratio 0·96 [95% CI 0·95 to 0·97]), and numeric memory maximum correct matches decreased by 0·025 in fully adjusted models. Surgeries were associated with smaller hippocampal volume (β=-5·76 mm³ [-7·89 to -3·64]) and greater white matter hyperintensities volume (β=100·02 mm³ [66·17 to 133·87]) in fully adjusted models. Surgeries were also associated with neurodegeneration of the insula and superior temporal cortex.

interpretationThis population-based study corroborates that surgeries are generally safe but cumulatively are associated with cognitive decline and neurodegeneration. Perioperative brain health should be prioritised for older and vulnerable patients, particularly those who have multiple surgical procedures.

fundingThe Australian and New Zealand College of Anaesthetists (ANZCA) Foundation and the University of Sydney.

Indexed as

Biological Specimen BanksMagnetic Resonance ImagingAdultAgedCognitionCognitive DysfunctionFemaleHospitalizationHumansMaleMiddle AgedNeurodegenerative DiseasesUK BiobankUnited Kingdom

Identifiers

PMID39245058
PMCPMC11460833

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.