A new study published in BMJ Open sheds light on the cognitive recovery of elderly patients following hip replacement surgery, highlighting the role of psychological factors in postoperative outcomes.
The research, conducted at Karolinska University Hospital in Huddinge, examined 40 patients with an average age of 73 undergoing total joint arthroplasty—a common procedure among older adults. The study aimed to explore the link between patients’ subjective cognitive experiences, performance-based assessments, and biological markers in the blood.
Delayed neurocognitive recovery, formerly known as postoperative cognitive dysfunction, is a frequent concern in elderly surgical patients. Researchers used a mixed-method approach, combining standardized neurocognitive tests, blood marker analysis for neuroinflammation, and qualitative evaluations through interviews and questionnaires.
Findings revealed that five patients exhibited delayed neurocognitive recovery according to performance-based tests. However, many more reported cognitive symptoms—particularly issues with executive function and fatigue—that were not always reflected in the objective assessments.
“Psychological factors, such as a sense of control and low mood, played a significant role in cognitive recovery and daily functioning,” said Anahita Amirpour, lead author and doctoral student at the Department of Neurobiology, Care Sciences, and Society. “The level of psychological well-being appears to influence postoperative cognitive recovery.”
Overall, patients reported a low quality of recovery, with a global postoperative recovery score of 40.9. The discrepancy between subjective cognitive decline and test results highlights the need for a more comprehensive approach to evaluating recovery.
“Future research should include long-term follow-ups, fatigue assessments, and evaluations of daily activities,” Amirpour emphasized. “A multidisciplinary team is crucial to effectively support patients’ recovery.”
The study underscores the complexity of cognitive recovery after surgery and the importance of integrating psychological support into postoperative care strategies.
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