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Yamagata Med J（ISSN 0288-030X）2021；39
須田，元木，新宮，斎藤，矢萩，小杉，加賀谷，櫻田
（2）
：92-101
DOI 10.15022/00005044
Impact of pulmonary and gastrointestinal surgery on cognitive
function in elderly patients
Yoshie Suda＊，＊＊， Maki Motoki＊＊， Megumi Shingu＊，＊＊＊， Shizuka Saito＊，＊＊，
Tomoko Yahagi＊，＊＊， Naoko Kosugi＊＊， Mayumi Kagaya＊＊， Kaori Sakurada＊＊＊＊
Yamagata University Faculty of Medicine, Graduate School of Nursing
＊＊
Division of Nursing, Yamagata University Hospital
＊＊＊
Yoshioka Hospital
＊＊＊＊
Department of Fundamental Nursing, Yamagata University Faculty of Medicine, School of Nursing
ABSTRACT
Background: Due to the significant increase in life expectancy, widespread use of minimally invasive
surgery, and improvements in perioperative management, the number of surgeries performed on
the elderly continues to increase. This increase has focused attention on postoperative cognitive
dysfunction（POCD）in elderly patients. We investigated the incidence of cognitive dysfunction in
elderly patients after surgery, and examined factors that affect POCD.
Materials and Methods: Fifty-two patients aged 65 years or older undergoing planned pulmonary
or gastrointestinal surgery under general anesthesia were included. Cognitive function was assessed
using the MMSE（Mini-Mental State Examination）prior to and one month after surgery. Patients
were divided into two groups, those in whom the MMSE score decreased by 3 or more points after
surgery and those in whom it remained unchanged or improved.
Results: At 1 month postoperatively, 10 patients showed a decrease in MMSE score of 3 or more
points compared to preoperative score, while 42 patients showed no change or an improvement.
Operation and anesthesia times were significantly longer in the decreased MMSE group（p=0.01 and
p<0.01, respectively）
, suggesting that longer surgery and anesthesia times may increase the risk of
cognitive decline due to greater physical invasiveness.
Conclusion: In these elderly patients undergoing pulmonary or gastrointestinal surgery, operation
time and duration of anesthesia were positively associated with cognitive decline.
Keywords: elderly patients, surgery, Postoperative cognitive dysfunction, POCD
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