SynthesisAnnals of African medicine2026
Cognitive Impairment and Postoperative Outcomes in Patients Undergoing Primary Total Hip Arthroplasty and Primary Total Knee Arthroplasty: A Systematic Review and Meta-analysis.
Synthesis in Annals of African medicine, 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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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.
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Who cites it
1 citing paper in PubMed.
- Frailty across Hip arthroplasty pathways: vulnerability domains, outcomes, and implications for care-a narrative review.Frontiers in surgery · 2026Review
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTotal hip arthroplasty (THA) and total knee arthroplasty (TKA) are commonly performed procedures in older adults. Preoperative cognitive impairment, including mild cognitive impairment, dementia, and frailty-related cognitive decline, may adversely affect postoperative recovery and outcomes. However, the magnitude of this association in arthroplasty patients remains incompletely defined.
objectiveTo evaluate the association between preoperative cognitive impairment and postoperative outcomes in older adults undergoing primary THA or TKA.
methodsA systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. PubMed and Scopus were searched for studies evaluating preoperative cognitive status and postoperative outcomes in patients aged ≥60 years undergoing THA or TKA. Eligible studies assessed cognition using validated tools or clinical diagnoses and reported postoperative neurocognitive or clinical outcomes. A random-effects meta-analysis using the Restricted Maximum Likelihood estimator was performed. Pooled effect estimates were expressed as odds ratios (ORs) with 95% confidence intervals (CIs).
findingsTen studies involving 10,573 patients were included. Preoperative cognitive impairment was consistently associated with adverse postoperative outcomes, including postoperative delirium, postoperative cognitive dysfunction, long-term cognitive decline, nonhome discharge, and mortality. The pooled analysis demonstrated a significant association between preoperative cognitive impairment and adverse postoperative outcomes (OR 2.38; 95% CI 1.78-2.98; P < 0.001). Although substantial heterogeneity was observed (I² = 76.7%), the direction of effect was consistent across studies.
conclusionPreoperative cognitive impairment more than doubles the risk of adverse postoperative outcomes following THA and TKA. Routine cognitive screening should be incorporated into preoperative assessment to identify high-risk patients and support perioperative brain health strategies aimed at improving surgical outcomes.
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