Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jun;64(6):1341-6.
doi: 10.1111/jgs.14130.

Cognitive Reserve and Postoperative Delirium in Older Adults

Amanda Tow  1 , Roee Holtzer  2 , Cuiling Wang  1 , Alok Sharan  3 , Sun Jin Kim  3 , Aharon Gladstein  3 , Yossef Blum  3 , Joe Verghese  2   4
Affiliations

Cognitive Reserve and Postoperative Delirium in Older Adults

Amanda Tow et al. J Am Geriatr Soc. 2016 Jun.

Abstract

Objectives: To examine the role of cognitive reserve in reducing delirium incidence and severity in older adults undergoing surgery.

Design: Prospective cohort study.

Setting: Hospital.

Participants: Older adults (mean age 71.2, 65% women) undergoing elective orthopedic surgery (N = 142).

Measurements: Incidence (Confusion Assessment Method) and severity (Memorial Delirium Assessment Scale) of postoperative delirium were the primary outcomes. Predictors included early- (literacy) and late-life (cognitive activities) proxies for cognitive reserve.

Results: Forty-five participants (32%) developed delirium. Greater participation in cognitive activity was associated with lower incidence (odds ratio = 0.92 corresponding to increase of 1 activity per week, 95% confidence interval (CI) = 0.86-0.98, P = .006) and severity (B = -0.06, 95% CI = -0.11 to -0.01, P = .02) of delirium after adjustment for age, sex, medical illnesses, and baseline cognition. Greater literacy was not associated with lower delirium incidence or severity. Of individual leisure activities, reading books, using electronic mail, singing, and computer games were associated with lower dementia incidence and severity.

Conclusion: Greater late-life cognitive reserve was associated with lower delirium incidence and severity in older adults undergoing surgery. Interventions to enhance cognitive reserve by initiating or increasing participation in cognitive activities may be explored as a delirium prophylaxis strategy.

Keywords: cognitive reserve; delirium; epidemiology.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Post-surgical delirium incidence (%) by tertile of cognitive leisure activity (1a) and tertile of literacy (1b).
See this image and copyright information in PMC

Comment in

References

    1. Whitlock EL, Vannucci A, Avidan MS. Postoperative delirium. Minerva Anestesiol. 2011;77:448–456. - PMC - PubMed
    1. Witlox J, Eurelings LS, de Jonghe JF, et al. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: A meta-analysis. JAMA. 2010;304:443–451. - PubMed
    1. Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014;383:911–922. - PMC - PubMed
    1. Marcantonio E, Ta T, Duthie E, et al. Delirium severity and psychomotor types: their relationship with outcomes after hip fracture repair. J Am Geriatr Soc. 2002;50:850–857. - PubMed
    1. Stern Y. Cognitive reserve. Neuropsychologia. 2009;47:2015–2028. - PMC - PubMed

Publication types