DEVELOPMENT OF DEMENTIA IN ELDERLY PATIENTS WITH POSTOPERATIVE DELIRIUM FOLLOWING HIP FRACTURE SURGERY

Abstract

Introduction: Postoperative delirium (POD) is a prevalent and undesirable neurocognitive consequence that arises following surgery and anesthesia in geriatric adults. Patients experiencing postoperative delirium may be at increased risk of developing long-term postoperative cognitive dysfunction and dementia. However, it is still unclear how much postoperative delirium (POD) affects the likelihood of developing dementia in this patient population.

Objective: The aim of this study was to examine the association between the occurrence of postoperative delirium and the development of new-onset dementia in elderly patients within one year following hip fracture surgery.

Materials and Methods: The study included patients aged 65 and older who underwent surgical treatment for proximal femur fractures at the University Clinic for Traumatology and Orthopedics. Patients with pre-existing dementia or cognitive impairment were excluded. Preoperative cognitive status was evaluated using the Abbreviated Mental Test (AMT-10) and the Informant Questionnaire on Cognitive Decline in the Elderly – Short Form (IQCODE-SF). Postoperative delirium was assessed during hospitalization using the Confusion Assessment Method (CAM). Patients were followed for one year after surgery to identify newly diagnosed dementia through medical record reviews. Statistical analysis was performed with SPSS version 25.0.

Results: This pilot study involved 91 patients. Postoperative delirium occurred in 30 (32.97%) of them. At twelve-month follow-up, new-onset dementia was significantly more common in patients with postoperative delirium compared to those without POD (46.67% vs. 8.2%, p=0.000022). Multivariate logistic regression analysis showed that postoperative delirium was an independent predictor of dementia (OR = 9.765, 95% CI 2.939–22.452, p < 0.0001).

Conclusion: Postoperative delirium is a risk factor for subsequent dementia following hip fracture surgery. Elderly hip fracture patients who exhibit POD should be closely monitored for the development of dementia.