Neurology

doi: 10.25005/2074-0581-2019-21-1-60-65
COGNITIVE DYSFUNCTIONS IN PATIENTS OF MIDDLE, ELDERLY AND OLD AGE IN THE LONG-TERM PERIOD AFTER CHOLECYSTECTOMY

M.K. Gulov1, A.M. Safarzoda2

1Department of General Surgery № 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2City Research Center for Resuscitation and Detoxification, Dushanbe, Republic of Tajikistan

Objective: To study the state of cognitive dysfunction in patients of middle, elderly and old age in the long-term period after cholecystectomy

Methods: A study conducted on the state of cognitive dysfunctions in 306 patients with cholelithiasis, operated on at the City Clinical Emergency Hospital for the period 2012 to 2017. Long-term results studied at 12 and 24 months after cholecystectomy. Depending on age, the subjects divided into 3 groups: middle, elderly, and old (senile) age. The study included a standardized neurological examination on a brief scale of neuropsychological testing, «Examination of mental status» and a quantitative assessment of the «Drawing watches» test; cognitive impairment determined by the performance of attention «The arrangement of numbers according to the method of Wexler». In addition, the following tests conducted distribution and switching of attention according to Schulte; selectivity of attention by Munsterberg; Bourdon correction method and intellectual liability assessment

Results: 26 (25.4%) middle-aged patients diagnosed with mild cognitive dysfunction. In 28 (27.4%) elderly patients, cognitive impairment characterized by the presence of a moderate degree of cognitive dysfunction. In 39 (38.2%) patients of senile age, cognitive impairment manifested by the inability to memorize new information, as well as to reproduce the information that was already available that however did not lead to social deadaptation.

Conclusions: Operative-anesthetic trauma has a negative impact on the state of cognitive functions in elderly and senile patients with a non-burdened neuropsychiatric history in the late postoperative period after cholecystectomy. The prevalence of cognitive impairment in the late postoperative period after cholecystectomy diagnosed in 27.4% of elderly patients and in 38.2% of old patients. The clinical picture of late postoperative cognitive dysfunction in the patients observed and expressed in a decrease in mental performance, attention, memory, distribution and switching of attention, concentration rate and accuracy, and intellectual liability, which was the cause of their social discomfort and reducing the quality of life.

Keywords: Age-related cognitive dysfunctions , cholelithiasis, cholecystectomy.

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References
  1. Zakharov VV. Rasprostranyonnost’ i lechenie kognitivnykh narusheniy v nevrologicheskoy klinike (rezul’taty Vserossiyskogo issledovaniya «Prometey») [The prevalence and treatment of cognitive disorders in the neurological clinic (the results of the All-Russian study «Prometheus»)]. Consilium medicum. 2008;2;114-7.
  2. Petrova NN. Kognitivnye rasstroystva v pozhilom vozraste i ikh korrektsiya [Cognitive disorders in the elderly patients and their correction]. Rossiyskiy semeynyy vrach. 2019;3:14.
  3. Prasmytskiy OT, Kostrova EM. Metodika snizheniya kognitivnykh rasstroystv pri laparoskopicheskoy kholetsistektomii, provedyonnoy v usloviyakh obshchey anestezii [A technique of reducing cognitive disorders in laparoscopic cholecystectomy performed under general anesthesia]. Meditsinskiy zhurnal. 2009;4:82-4.
  4. Abdulloev DA, Kurbonov KM. Kompleksnaya diagnostika i lechenie khronicheskikh narusheniy duodenal’noy prokhodimosti pri kal’kulyoznom kholetsistite [Comprehensive diagnosis and treatment of chronic disorders of duodenal obstruction in calculous cholecystitis]. Vestnik Avitsenny [Avicenna Bulletin]. 2009;1:29-36.
  5. Vakhnina NV. Vedenie patsientov s kognitivnymi narusheniyami [Treatment of patients with cognitive dysfunctions]. Spravochnik poliklinicheskogo vracha. 2013;3:40-5.
  6. Marochkov AV. Razvitie kognitivnykh rasstroystv u patsientov posle abdominal’nykh khirurgicheskikh vmeshatel’stv s mnogokomponentnoy endotrakheal’noy anesteziey [Development of cognitive disorders in patients after abdominal surgery with multicomponent endotracheal anesthesia]. Vestnik Vitebskogo gosudarstvennogo meditsinskogo universiteta. 2013;1(12):64-70.
  7. Kulikov VA, Ayrapetyan AT, Proshchaev KI. Prichiny kognitivnykh rasstroystv u pozhilykh lyudey v posleoperatsionnom periode [Causes of cognitive disorders of elderly patients in the postoperative period]. Sovremennye problemy nauki i obrazovaniya. 2015;3:246
  8. Novikova IA, Solovyov AG, Popov VV. Algoritm diagnostiki kognitivnykh i emotsional’nykh rasstroystv u lits pozhilogo i starcheskogo vozrasta [The algorithm of the diagnosis of cognitive and emotional disorders in the elderly and late elderly patients]. Uspekhi gerontologii. 2017;30(3):442-9.
  9. Sidenkova AP. Kognitivnye rasstroystva pozdnego vozrasta – aktual’naya meditsinskaya, sotsial’naya, psikhologicheskaya problema sovremennosti [Cognitive disorders of the late age – the current medical, social, psychological problem of modernity]. Ural’skiy meditsinskiy zhurnal. 2010;9:6-9.
  10. Lokshina AB. Nedementnye kognitivnye rasstroystva v pozhilom vozraste: sovremennye podkhody k diagnostike i lecheniyu [Non-dementia cognitive disorders in the elderly: current approaches in diagnosis and treatment]. Effektivnaya farmakoterapiya. 2013;15:34-40.
  11. Sidenkova AP. Osobennosti identifikatsii psikhicheskikh rasstroystv pozdnego vozrasta [Features of identification of mental disorders of late age]. Rossiyskiy psikhiatricheskiy zhurnal. 2009;1:44-8.
  12. Yahno NN, Zakharov VV, Lokshina AB, Koberskaya NN, Mkhitryan EA. Dementsii: rukovodstvo dlya vrachey [Dementia: A guide for doctors]. Moscow, RF: MEDpress-inform; 2010. 272 p.
  13. Lokshina A. Sovremennye predstavleniya o nedementnykh kognitivnykh rasstroystvakh [Current state of on non-dementia cognitive disorders]. Effektivnaya farmakoterapiya. 2015;1:36-44.
  14. Rakhmatulloev R, Norov AKh, Kurbonov DM, Dzhonboboev BB, Khamroev UM. Rezul’taty khirurgicheskogo lecheniya ostrogo kal’kulyoznogo kholecistita u bol’nykh pozhilogo i starcheskogo vozrasta s primeneniem razlichnykh metodik [Results of surgical treatment of acute calculous cholecystitis in elderly and late elderly patients using various techniques]. Vestnik Avitsenny [Avicenna Bulletin]. 2011;4:29-34.
  15. Fedoseev AV, Budarev VN. Vliyanie operatsionnoy travmy na chastotu vozniknoveniya posleoperatsionnoy kognitivnoy disfunktsii [The effect of operative trauma on the incidence of postoperative cognitive dysfunction]. Rossiyskiy mediko-biologicheskiy vestnik im. akademika I.P. Pavlova. 2009;2:119-23.
  16. Boos GL, Soares LF, Filho GD. Postoperative cognitive dysfunction: Prevalence and associated factors. Rev Bras Anestesiol. 2005;55:517-24

Authors informations:

Gulov Mahmadshoh Kurbonalievich , Doctor of Medical Sciences, Full Professor, Professor of the Department of General Surgery № 1, Avicenna Tajik State Medical University

Safarzoda Abdullo Mumin , Candidate of Medical Sciences, Director of the City Research Center for Resuscitation and Detoxification

Address for correspondence:

Safarzoda Abdullo Mumin
Candidate of Medical Sciences, Director of the City Research Center for Resuscitation and Detoxification

734003, Republic of Tajikistan, Dushanbe, Sanoi str., 33

Tel.: +992 (985) 210400

E-mail: abdullo-1969@mail.ru

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