According to a recent Wall Street Journal article (“A Mental Test Before Surgery”), more hospitals are testing the mental fitness of older patients before surgery due to evidence that it can accelerate cognitive decline. This can help doctors anticipate how a patient will tolerate surgery and follow care instructions after discharge. It also can assist families in deciding whether surgery is worth the potential risks.
Patients with dementia who undergo surgery are at a higher risk for postoperative delirium and are more likely to have worse surgical outcomes, longer hospital stays, functional declines and death. Despite these known risks, the article explains that as many as 81% of patients who meet the criteria for dementia have never had a formal diagnosis. Dr. Stephanie Rogers, a geriatrician, is quoted in the article that without a formal cognitive assessment, “we are consenting all these people for major operations they may not understand.” In fact, the American College of Surgeons and the American Geriatrics Society recommend that hospitals assess any patient over age 65 for cognitive impairment as part of a preoperative evaluation.
If you have an older loved one who is considering surgery, be sure to discuss with the surgeon whether a cognitive evaluation is warranted. You certainly will want to know all the potential risks beforehand.