Journal of Geriatric Psychiatry and Neurology

 

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Journal of Geriatric Psychiatry and Neurology, Vol. 3, No. 4, 184-191 (1990)
DOI: 10.1177/089198879000300402

Reviews

Effects of Surgery on the Mental Status of Older Persons. A Meta-analytic Review

Arthur G. Cryns, PhD

Multidisciplinary Center on Aging, School of Medicine, State University of New York at Buffalo, Buffalo, NY 14214

Kevin M. Gorey, MSW

Multidisciplinary Center on Aging, School of Medicine, State University of New York at Buffalo, Buffalo, NY 14214

Marion Z. Goldstein, MD

Department of Psychiatry

The data bases of 18 empirical studies were combined into one comprehensive data set and subjected to meta-analysis. The following trends were observed: (1) surgery has a significantly decompensating impact on the mental status of older persons, and the average effect size observed is modest (r = .37); (2) for all mental status measures included in the review (cognition, delirium and affect), effect size appears to be significantly moderated by patient age; (3) patient sex may be predictive of the kind of mental impairment that is most likely to occur within an older surgery population, with women manifesting a greater affinity for delirious and men for cognitive decompensation; (4) most existing research within this domain of study is either purely descriptive or anecdotal: of 46 studies reviewed, only 18, or 39.1% of the total published output, were of sufficient methodologic rigor to allow for scientifically valid effect-size computations. The implications of these findings for future research are discussed. ( J Geriatr Psychiatry Neurol 1990;3:184-191).


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