GAINESVILLE, Fla. (Ivanhoe Newswire) — About one in six patients over the age of 60 experience confusion or delirium after elective surgery. When a person becomes delirious, they are more likely to suffer postoperative complications, require longer hospital stays and even die. Now a new program at the University of Florida is working to predict who is at risk and reduce the threat.
Debbie Hill loves looking at photos of her late husband James’ adventures. James loved being social, sailing, and serenading his loved ones.
“He was just somebody who lit up a room,” said Hill.
But as James got older, he was diagnosed with mild Alzheimer’s, which worried Hill when he went under the knife. The first two times he had surgery his anesthesia was modified, but the third time when he went under regular general anesthesia for a broken hip …
“He was delirious. He was confused. Sometimes he hallucinated. It broke my heart to see him not be the person that I knew him to be.” Hill shared.
Hill and James’ story is not uncommon.
Catherine Price, PhD, ABPP, Associate Professor of Clinical and Health Psychology, Anesthesiology Co-Director, Perioperative Cognitive Anesthesia Network at University of Florida said, “Approximately a third of the individuals were having changes in their memory and thinking after having anesthesia and surgery.” (Read Full Interview)
Catherine Price runs the Perioperative Cognitive Anesthesia Network, or PeCAN, where she studies how someone’s brain health before surgery can impact their recovery. Before surgery they run an assessment of tests, such as having patients draw a clock to …
“Check attention, working memory, some planning, some prospective memory,” said Price.
If the patient performs poorly …
“We can alert the anesthesiology and the surgery team and the geriatric nutritionist so they can optimize the person’s care,” Price explained.
… and limit the risk for delirium.
Hill’s husband, James, did not take part in PeCAN, but his story was a big inspiration in helping to launch the program at the University of Florida in 2017. After James died, his brain was donated to science for research.
Contributors to this news report include: Milvionne Chery, Field Producer; Roque Correa, Videographer; Cyndy McGrath, Supervising Producer; Hayley Hudson, Assistant Producer; Roque Correa, Editor.
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TOPIC: PECAN FOR BRAIN HEALTH
REPORT: MB #4475
BACKGROUND: As our population ages, there will be a greater need for elective surgeries among older adults; however, elective surgeries can be associated with significant harm. Delirium is one of the most common complications of surgery among older adults, and has been associated with prolonged hospitalization, death, and admission to long-term care. Multifactorial interventions with a focus on optimizing mobility, vision, hearing, hydration, cognition, and sleep have proven to be effective delirium prevention strategies in medical and surgical settings. Therefore, identifying patients at risk of delirium is important because clinicians can develop plans to mitigate this risk.
SIGNS: Other causes of cognition changes, such as a pre-existing dementia, need to be ruled out before a diagnosis of delirium is given to a patient. Because the symptoms of delirium and dementia are similar, delirium can sometimes be misdiagnosed as dementia. It is also important to note that postoperative delirium can remain unrecognized in older adults and not addressed by healthcare staff in up to 80 percent of delirium cases. The signs and symptoms of delirium can fluctuate in the individual during a 24- hour period. Each individual will vary in their presentation of delirium and some of the symptoms they may display include: reduced awareness of their environment, decreased ability to focus attention, easily distracted, changes in cognition such as memory impairment, language disturbance or disorientation, adversely affected recent memory disturbances, disorientation to time, place and person, language disturbances such as inability to name objects, write or present with rambling speech, and perceptual disturbance such as hallucinations, illusions or misinterpretations.
NEW RESEARCH: In conjunction with UF Anesthesia department, Catherine Price, PhD, ABPP, Associate Professor, Clinical and Health Psychology/Anesthesiology Co-Director, Perioperative Cognitive Anesthesia Network at the University of Florida has launched a Perioperative Cognitive Anesthesia Network (PeCAN) in the UF surgical center. The program includes interdisciplinary research, clinical, and training arms. This effort represents a stellar example of translation from clinical research to clinical care. The clinical program is housed in UF Health’s Pre-surgical Center where nurses and anesthesia clinical staff now routinely assess “cognitive vital signs”.
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Rossana Passaniti, Media Relations
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