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Rates of delirium after surgery are highest among older patients, occurring in up to 51 percent of those aged 65 and older. Previous research has also shown that depression is a major risk factor for delirium, which is a disoriented state marked by a sharp decrease in attention and mental abilities.
Twenty-three percent of the patients experienced delirium after surgery, the investigators found. Delirium occurred much more often in patients who had depression and pain before surgery, according to the study published recently in The Lancet Psychiatry.
Further analyses found that patients with both depression and high levels of pain before surgery had a 21 percent increased risk of delirium after surgery, compared with a 3 percent increased risk for those with no depression.
This suggests a strong interaction between pain and depression in boosting delirium risk, although it does not prove a cause-and-effect link, the researchers said.
"Our study demonstrates that the combination of higher symptoms of pain and depression increases delirium risk in older adults," study co-author Dr. Sharon Inouye, of the Harvard Medical School-affiliated Hebrew SeniorLife Institute for Aging Research, said in an institute news release.
"Doctors considering surgery for older patients should be aware of the delirium risk and potential contributions of pain and depressive symptoms in their preoperative evaluations," Inouye added.
-- Robert Preidt
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