Years back, my dad came out of the hospital with severe, irreversible dementia. True, he’d had brain surgery. The surgery was meant to correct the effects aging was having on scar tissue from his WWII brain injury. Still, the change in my dad post-surgery was dramatic, to put it lightly. At the time, medical people were not aware – or were not acknowledging – the risks of surgery and hospitalization for elders.
Through the years, I’ve answered anguished questions from readers telling their personal tale of a mother or father coming home from the hospital dramatically changed. I could empathize and tell them I understood their pain. But until the last couple of years, there’s been little scientific evidence to back up what many family members have witnessed firsthand.
Recently, the New Old Age blog ran a story titled After Hospitalization, Mental Trouble for Elderly Patients, telling of progress in recognizing the problem of elders who return from a hospitalization with mental issues they hadn’t faced before.
The blog noted a recent article in the journal Neurology, titled Cognitive decline after hospitalization in a community population of older persons, that reports on a study that concluded: “In old age, cognitive functioning tends to decline substantially after hospitalization even after controlling for illness severity and pre-hospital cognitive decline.”
Robert Wilson, PhD, lead author of the report, and a professor of neurological and behavioral sciences at Rush University Medical Center in Chicago, states that the cause for this mental decline is unclear. It’s possible that both the illness that hospitalized the patient and the treatments received could contribute to the elder’s decline.
According to the article, Wilson and his colleagues found “the rate of cognitive decline in older patients more than doubled after a hospital stay, generally affecting thinking and memory across the board...Essentially, it’s as if people became 10 years older, from a cognitive standpoint, than they actually were before a hospitalization.”
People enduring the longest hospitalizations, as well as patients who had started experiencing some memory problems before hospitalization, were found to be the most vulnerable to a negative outcome.
Delirium after hospitalization
“Hospital delirium,” a brain dysfunction characterized by sudden confusion and often agitation following hospitalization, was once thought to be transient. Newer studies are now finding that for as many as 20 percent of our elders, the effects of delirium remain, making it “one of the most common, dangerous and costly complications of hospital stays for the elderly.”
Sometimes there is no choice
In my dad’s case, there was no good choice about whether or not to have the surgery. He was doing well, but the scar tissue in his brain was beginning to dam up fluid. He would eventually have developed dementia from that fluid buildup, so the surgery to place a shunt in his brain for fluid drainage was necessary. This is generally a safe and effective surgery. Most likely, the surgery was flawlessly performed. Dad was just one of those people who experienced a “poor outcome.”
To Dad and the family, the “outcome” was devastating, but at the time, the disastrous results were unacknowledged by the clinicians. It’s heartening for me to see this issue of elders developing dementia after hospitalization researched, because only by digging deeply into management of elders as patients, surgical techniques and medications given, including anesthesia, will this tragic situation be understood and hopefully diminished.
Graham, J. (2012, March 23) After Hospitalization, Mental Trouble for Elderly Patients. The New York Times New Old Age Blog. Retrieved from http://newoldage.blogs.nytimes.com/2012/03/23/after-hospitalization-mental-trouble-for-elderly-patients/
Wilson, R.S., et al, (2012 March 21) Neurology, Cognitive decline after hospitalization in a community population of older persons. Retrieved from http://www.neurology.org/content/early/2012/03/21/WNL.0b013e31824d5894.abstract
Seliger, S. (201, November 2) Another Hospital Hazard for the Elderly. The New York Times New Old Age Blog. Retrieved from http://newoldage.blogs.nytimes.com/2011/11/02/another-hospital-hazard-for-the-elderly/
Published On: April 04, 2012