Pre and Postoperative Assessment of Depression and Cognitive Dysfunction Aged 65 Years or Older in Department of Surgery

Choi, Hong Yong

Abstract

BACKGROUNDS: As the lifetime is prolonged, the chances of operation of elderly people are increased concomitantly. In general, elderly patients have more frequent and severe psychiatric problems as depression and cognitive dysfunction than young patients. But, the prevalence rate of depression and cognitive dysfunction pre and postoperatively is known a little. Also, the delirium which makes the surgeon embarrassed is high in dementia and elderly patients even diagnosed normally preoperatively. We tried to know how many elderly people has depression and cognitive dysfunction pre and postoperatively, also how many elderly patients become delirious postoperatively. METHOD: We obtained questionnaires from 100 elderly patients(mean age 75.0) undergoing operation pre and postoperatively. We used Short Portable Mental Status Questionnaire(SPMSQ) which calculated the wrong answer for the fact to evaluate the cognitive dysfunction and short version of Geriatric Depression Scale(GDS) which calculated the wrong answer defined previously to study the depression. The depression was suggestted if GDS score was above 6 and cognitive dysfunction was suggested if SPMSQ score was above 3. The dementia and postoperative delirium patients were diagnosed and managed by the psychiatrist and the operator.
RESULTS
Pre and postoperative mean score of GDS was 10.1 and 9.5 respectively. Pre and postopera- tive incidence of depression was 65% and 67% respectively. Pre and postoperative mean errors of SPMSQ was 6.5 and 6.7 respectively. Pre and postoperative incidence of cognitive dysfunction was 30% and 31% respectively. The dementia patients were ten. The postoperative delirium patients were six. Three of them were dementia patients diagnosed preoperatively and the others had non-cognitive dysfunction preoperatively.
CONCLUSION
The incidence of depression and cognitive dysfunction in elderly patients is relatively high. And the postoperative delirium is high in dementia patients. Even the patients diagnosed non- cognitive dysfunction preoperatively have high incidence rate than young people. So, we must do critical care with elderly patients pre and postoperatively and know the appropriate management of depression and cognitive dysfunction to prevent prolonged hospitalization, poor quality of life and conflict with patient`s family.