Studies of Cognitive Dysfunction and Depression in Urologic Patients Aged 75 Years or Older, Pre and Post-operative Assessment

Jung, Jae Won; Lee, Kwang Soo

Abstract

PURPOSE: Cognitive impairment and psychiatric symptoms are relatively common in the elderly people. Recognizing them is important and mental status assessment may be needed for elderly patients to establish their competence for making a will, or for giving informed consent for procedure. We investigated the incidence of depression and cognitive dysfunction in geriatric patients undergoing surgery pre and postoperatively.
MATERIALS AND METHODS
A total of 50 patients 75 to 97 years old(mean age 80.5) were included in the study. Of the 50 patients 36 had benign prostatic hyperplasia, 5 prostate cancer and 9 had bladder tumor. We obtained questionnaires from 50 patients undergoing operation pre and postoperatively. We used two forms of questionnaires, Short Portable Mental Status Questionnaire(SPMSQ) and short version of Geriatric Depression Scale(GDS).
RESULTS
Pre and postoperative mean score of GDS was 8.8 and 8.4, respectively. Pre and postoperative mean error of SPMSQ was 0.9 and 0.6, respectively. The incidence of depression and cognitive dysfunction was 80.0%(40/50 patients) and 14.0%(7/50 patients), respectively. Of 7 patients with cognitive dysfunction, 6 patients revealed delirium but remaining one was difficult to differentiate delirium from dementia until discharge. Patients with depression increased(from 40 to 41 patients) postoperatively. In contrast, patients with cognitive dysfunction decreased(from 7 to 2 patients) at discharge.
CONCLUSIONS
A screening assessment of depression and cognitive function is recommended before and after urologic surgery of elderly patients to predict prolonged hospitalization, functional dependency and legal problems.