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
. 2022 Feb 18:2022:5372603.
doi: 10.1155/2022/5372603. eCollection 2022.

Early Cognitive Dysfunction in Elderly Patients after Total Knee Arthroplasty: An Analysis of Risk Factors and Cognitive Functional Levels

Shengjie Ren  1 , Fang Yuan  1 , Shu Yuan  1 , Chuanbo Zang  1 , Yanan Zhang  1 , Bao Lang  2
Affiliations

Early Cognitive Dysfunction in Elderly Patients after Total Knee Arthroplasty: An Analysis of Risk Factors and Cognitive Functional Levels

Shengjie Ren et al. Biomed Res Int. .

Abstract

Background: Cognitive dysfunction after total knee arthroplasty (TKA) is very common in elderly patients. Postoperative cognitive dysfunction (POCD), as a form of cognitive dysfunction, may affect patients' short- and long-term recoveries. The identification of meaningful risk factors may help reduce the occurrence of POCD in the future.

Objective: Our goal was to retrospectively investigate the risk factors for early POCD in elderly patients undergoing TKA and to further analyze the relationship between the intensity of risk factors and the level of cognitive function.

Methods: The related indicators and the Montreal Cognitive Function Assessment Scale (MOCA) scores of 105 elderly patients were collected by searching the electronic case system. According to the postoperative MOCA score, patients were divided into three groups: normal group (group N), mild POCD group (group M), and severe POCD group (group S). SPSS 25.0 software was used for statistical analyses.

Results: At baseline, the preoperative MOCA score was significantly different in patients with POCD (P ≤ 0.001), while other baseline indicators were not significantly different. In terms of changes in hemoglobin levels, statistically significant differences were observed between group M, group S, and group N (P = 0.039). Among inflammatory indicators, only postoperative CRP levels showed a statistically significant difference in patients with POCD (P = 0.041). Postoperative pain was also significantly different among the three groups (P = 0.009). The multivariate regression analysis revealed that a low preoperative MOCA score and severe postoperative pain were independent risk factors for mild and severe cognitive impairment, while a high postoperative CRP level was only an independent risk factor for mild cognitive impairment.

Conclusions: Our study found that the level of preoperative cognitive function, postoperative CRP level, and postoperative pain were independent risk factors for POCD. Moreover, the levels of preoperative cognitive function and postoperative pain were more strongly correlated with severe POCD than postoperative CRP levels.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest regarding the publication of this article to declare.

Figures

Figure 1
Figure 1
Montreal cognitive assessment (MoCA), Beijing version (in English).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Van Sinderen K., Schwarte L. A., Schober P. Diagnostic criteria of postoperative cognitive dysfunction: a focused systematic review. Anesthesiology Research and Practice . 2020;2020:13. doi: 10.1155/2020/7384394.7384394 - DOI - PMC - PubMed
    1. McDonagh D. L., Mathew J. P., White W. D., et al. Cognitive function after major noncardiac surgery, apolipoprotein E4 genotype, and biomarkers of brain injury. The Journal of the American Society of Anesthesiologists . 2010;112(4):852–859. doi: 10.1097/ALN.0b013e3181d31fd7. - DOI - PMC - PubMed
    1. Nasreddine Z. S., Phillips N. A., Bédirian V., et al. The Montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society . 2005;53(4):695–699. doi: 10.1111/j.1532-5415.2005.53221.x. - DOI - PubMed
    1. Rundshagen I. Postoperative cognitive dysfunction. Deutsches Ärzteblatt International . 2014;111(8):119–125. doi: 10.3238/arztebl.2014.0119. - DOI - PMC - PubMed
    1. Claes A. J., de Backer S., Van de Heyning P., Gilles A., Van Rompaey V., Mertens G. Postoperative cognitive dysfunction after cochlear implantation. European Archives of Oto-Rhino-Laryngology . 2018;275(6):1419–1427. doi: 10.1007/s00405-018-4976-6. - DOI - PubMed