It’s quite normal to feel anxious before “going under the knife.” Surgery, especially major surgery, is daunting for anyone at any age.
But even if all goes well and you’re expected to make a full physical recovery, there’s one problem that can present itself after surgery, particularly in older folks.
I’m talking about post-operative delirium. And if you fall victim, it can mean a longer hospital stay, slower recovery, and an increased risk of memory loss—even death.
But there’s good news. If you do this one, simple thing, then you can lower your risk of post-operative delirium by more than 60 percent.
Post-operative delirium is characterized by disturbances in attention, awareness, and cognition as the patient recovers from surgery and beyond.
One Harvard Medical School doctor describes post-operative delirium in the journal Lancet as “a common, serious, costly, under-recognized and often fatal condition… affecting up to 50 percent of hospitalized seniors.”1
Memory Decline Steeper Than Dementia
Even more alarming, while post-operative delirium was once considered a temporary condition, doctors now believe that in moderate to severe cases memory loss is long-term and can be worse than the memory loss that’s suffered with dementia.
“The declines in cognition may be both substantial and long-term and most notably exceed the rate of decline observed for patients with dementia,” wrote another Harvard Medical School doctor in the Journal Alzheimer’s Disease.2
Researchers have tested drugs to prevent and treat post-operative delirium, but their studies have yet to prove successful.
The only treatment with any measurable results requires a skilled interdisciplinary team to provide a broad range of post-operative therapies ranging from stimulating activities, sleep enhancement strategies, exercise, dehydration prevention, as well as avoiding certain medications and arranging for specialized family support.
This approach is called the Hospital Elder Life Program, or HELP, and is widely used for hospitalized patients over the age of 70.
This model has certainly improved patient outcomes, but researchers from Ohio State College of Medicine wanted to test a simpler approach that involved no staff and could be carried out easily by patients themselves at home before their hospital stay.
The Secret of Neurobics
Researchers enrolled 251 patients aged between 63 and 71 who were about to undergo major surgery with general anesthesia and expected a hospital stay of at least three days.
Half were given a tablet loaded with a brain games app that provided activities targeting memory, speed, attention-span and problem-solving functions. Researchers asked the patients to use the app for an hour a day in the days leading up to the operation. The other half acted as controls.3
The brain games group, who on average completed about 4.5 hours of “neurobics” activities, enjoyed more than a 40 percent reduction in delirium compared to the control group. Those who played between five and ten hours had their risk cut in half, and the patients who performed exercises for more than ten hours saw a 61 percent reduction in risk.
Even more exciting, the brain gamers were also less likely to be admitted to an intensive care unit during their post-operative hospital stay.
Dr. Michelle Humeidan, who led the study, said, “Essentially, your brain can be prepared for surgery, just as the body can, by keeping your mind active and challenged.” And for those who don’t have a smartphone she adds some encouraging words, “Using the app was ideal for this study because we could easily track how long and how often patients were playing.
“But things like reading the newspaper, doing crossword puzzles or anything you enjoy to challenge your mind for an hour each day may improve your mental fitness and help prevent delirium as well.”4
The whole study tends to confirm some advice we’ve often given in these pages: Use your brain or lose it. Memory and cognition benefit from being put to work, and wither away if left unused.