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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2018

Open Access 01-01-2018 | Gastrointestinal Oncology

Vitamin Status and the Development of Postoperative Cognitive Decline in Elderly Surgical Oncologic Patients

Authors: Linda B. M. Weerink, MD, Barbara L. van Leeuwen, MD PhD, Sofie A. M. Gernaat, MSc, Anthony R. Absalom, MD PhD, Monique G. Huisman, MD, Hanneke van der Wal- Huisman, MSc, Gerbrand J. Izaks, MD PhD, Geertruida H. de Bock, PhD

Published in: Annals of Surgical Oncology | Issue 1/2018

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Abstract

Background

This study aimed to evaluate the influence that serum levels of vitamin B12, folate, and homocysteine have on the development of short-term postoperative cognitive decline in the elderly surgical oncology patient.

Methods

This study was part of a prospective cohort study focused on postoperative cognitive outcomes for patients 65 years of age or older undergoing surgery for a solid malignancy. Postoperative cognitive decline was defined as the change in the combined results of the Ruff Figural Fluency Test and the Trail-Making Test Parts A and B. Patients with the highest change in scores 2 weeks postoperatively compared with baseline were considered to be patients with cognitive decline. Patients with the lowest change were considered to be patients without cognitive decline. To analyze the effect of vitamin levels on the changes in postoperative cognitive scores, uni- and multivariate logistic regression analysis were performed.

Results

The study enrolled 61 patients with and 59 patients without postoperative cognitive decline. Hyperhomocysteinemia was present in 14.2% of the patients. Patients with postoperative cognitive decline more often had hyperhomocysteinemia (27.9 vs 10.2%). Hyperhomocysteinemia was associated with a higher chance for the development of postoperative cognitive decline (odds ratioadjusted, 11.9; 95% confidence interval, 2.4–59.4). Preoperative vitamin B12 or folate deficiency were not associated with the development of postoperative cognitive decline.

Conclusion

Preoperative hyperhomocysteinemia is associated with the development of postoperative cognitive decline. The presence of preoperative hyperhomocysteinemia could be an indicator for an increased risk of postoperative cognitive decline developing in the elderly.
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Metadata
Title
Vitamin Status and the Development of Postoperative Cognitive Decline in Elderly Surgical Oncologic Patients
Authors
Linda B. M. Weerink, MD
Barbara L. van Leeuwen, MD PhD
Sofie A. M. Gernaat, MSc
Anthony R. Absalom, MD PhD
Monique G. Huisman, MD
Hanneke van der Wal- Huisman, MSc
Gerbrand J. Izaks, MD PhD
Geertruida H. de Bock, PhD
Publication date
01-01-2018
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 1/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-017-6118-6

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