Subtle attentional deficits in the absence of dementia are associated with an increased risk of post-operative delirium

Dement Geriatr Cogn Disord. 2007;23(6):390-4. doi: 10.1159/000101453. Epub 2007 Mar 29.


Background: Previously, key studies of the risk profile for post-surgical delirium have focused on general medical and non-elective patients, few have examined elective cohorts. Accurate prediction is imperative for clinical trials and prevention strategies.

Aims/hypothesis: Our hypothesis was that subtle pre-operative impairments of attention will be associated with risk of post-operative delirium.

Method: A prospective study evaluating pre- and post-operative neuropsychological performance in older (> or =70) consecutive elective admissions for orthopaedic surgery, and free of dementia (n = 100) was initiated in a general medical hospital.

Results: Pre-operative attentional deficits were closely associated with delirium. Patients who developed post-surgical delirium had significantly slower mean reaction times (p < or = 0.011) and greater variability of reaction time (p = 0.017). A 4- to 5-fold increased risk of delirium was observed for people one standard deviation above the sample means on these variables.

Conclusions: The present study describes a measurement of attentional performance which could form the basis of a neuropsychological marker of delirium.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Attention / physiology*
  • Attention Deficit Disorder with Hyperactivity / complications*
  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Chi-Square Distribution
  • Cognition Disorders / complications*
  • Cognition Disorders / diagnosis
  • Delirium / etiology*
  • Delirium / psychology
  • Elective Surgical Procedures / adverse effects
  • Female
  • Humans
  • Male
  • Neuropsychological Tests
  • Postoperative Complications / etiology*
  • Postoperative Complications / psychology
  • Predictive Value of Tests
  • Reaction Time / physiology
  • Risk Factors
  • Statistics, Nonparametric