SynthesisBritish journal of anaesthesia2026
Psychological factors associated with postoperative cognitive outcomes in older adults: a systematic review and meta-analysis.
Synthesis in British journal of anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Cognitive function in patients undergoing robotic radical prostatectomy - 1 year follow up.Journal of robotic surgery · 2026Article
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6 authors.
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Abstract
backgroundOlder adults face increased risk of postoperative cognitive complications, which can prolong hospitalisation and impair function. Preoperative psychological factors may contribute to these cognitive outcomes, yet their impact remains unclear. This systematic review with meta-analysis synthesises evidence on associations between psychological factors and postoperative cognitive outcomes in older adults.
methodsA systematic review and meta-analysis, including synthesis without meta-analysis, of studies reporting preoperative psychological factors and postoperative cognitive outcomes in adults aged 60 yr or older was conducted. Five databases (Medline, Embase, Web of Science, PsycINFO, and CINAHL) were searched. The Newcastle Ottawa Scale or Cochrane Risk of Bias 2.0 tool was used for quality appraisal. Where feasible, random-effects meta-analyses were conducted alongside P-value synthesis and vote counting based on direction of effect.
resultsThirty studies (n=6714 subjects) were included. Four categories of psychological factors were identified: depression, anxiety, personality traits, and stress-related factors. Postoperative delirium was the most reported outcome, assessed in all studies with incidence ranging from 9% to 55.6%. Two studies assessed delayed neurocognitive recovery or postoperative neurocognitive disorder. In studies reporting effect estimates, the random-effects model showed a non-significant association between depression and postoperative delirium (odds ratio, 1.08; 95% confidence interval, 0.97-1.20). In the synthesis without meta-analysis, there was evidence of an association between the psychological factors and postoperative cognitive outcomes in 28 studies (P<0.001).
conclusionsDepression was the most consistently reported psychological risk factor for postoperative delirium in older adults, whereas evidence for anxiety, personality traits, and stress is limited. Multidimensional, standardised cognitive assessments are needed, and future studies should evaluate interventions to reduce risk and improve postoperative cognitive outcomes. SYSTEMATIC REVIEW PROTOCOL: PROSPERO (CRD42024581115).
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