Abstract
Background/aim Hypertension is an important risk factor for cognitive impairment. This study explored whether elderly patients with stage I hypertension (HPs) and normotensive patients (NPs) showed differences in the recovery of postoperative attention network function according to the attentional network test (ANT) performance.Materials and methods Of 110 patients screened, 25 HPs and 25 NPs completed this study. The Mini-Mental State Examination (MMSE) was applied to all participants before the operation and the ANT (on days 2 and 7) after the operation. All participants completed 1 day preoperatively and the ANT on postoperative days (PODs) 2 and 7.Results Compared with NPs, HPs had significantly lower alerting network effect scores and more difficulty resolving conflict on POD 7. However, no significant difference was observed between the groups on POD 2. Orienting network performance was similar between the groups at all time points. Significant differences in alerting and executive control network performances were observed between PODs 2 and 7 in each group.Conclusion HPs showed selective cognitive impairment at different time points following elective hip or knee arthroplasty. Compared with NPs, during the first postoperative week, HPs were more likely to experience delayed recovery of alerting and executive control network function, but not orienting network function.
Highlights
Loss of cognitive function is one of the most devastating manifestations of aging and vascular disease
Significant differences in alerting and executive control network performances were observed between postoperative days (PODs) 2 and 7 in each group
Of the 110 patients screened in this study, 9 male and 7 female patients were excluded because of serious lung or heart disease (ASA physical status III or IV), 3 male and 2 female patients were excluded because of insufficient oral bowel preparation, 2 male and 3 female patients were excluded due to the alteration of the anesthetic plans, and 16 male and 18 female patients declined to participate postoperatively
Summary
Loss of cognitive function is one of the most devastating manifestations of aging and vascular disease. Chronic hypertension has been associated with increased risks of cognitive decline, vascular dementia, and Alzheimer disease [1], and is regarded as a key modifiable risk factor for age-related dementia [2]. Other studies have shown that low blood pressure (BP) contributes to brain atrophy and more rapid cognitive impairment in hypertensive patients with no apparent cerebrovascular disease [3,5]. These contradictory effects may be explained by differences in antihypertensive agents used, patient characteristics, and the extent of blood pressure reduction [3].
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