Informed Consent and Older Adults: Discussing the Risks of Developing Cognitive Dysfunction after Surgery
February 28, 2018 | Strategic Insights for Health System
An estimated 12% of patients older than age 60 with normal preoperative cognitive function develop cognitive dysfunction—consisting of deficits in attention, language, processing speed, memory, and problem solving—within three months after noncardiac surgery, note the authors of a special article in the February 2018 issue of Anesthesia and Analgesia. Therefore, the authors state, older patients considering surgery under general anesthesia or spinal, epidural, or major nerve blockade should be informed of the risk of postoperative cognitive dysfunction. Much remains unknown about postoperative cognitive dysfunction. For example, it is uncertain whether and how long the condition persists; no prospective studies have examined the condition at 12 months after surgery or beyond. In addition, extant studies have not involved neurologists to rule out other causes of postoperative cognitive decline. However, principles of informed consent call for the disclosure of risks that are foreseeable and material, and what is known about postoperative cognitive dysfunction satisfies both criteria, the authors write.