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Current status and influencing factors of early delayed neurocognitive recovery in older adult patients after major orthopedic surgery under general anesthesia: a cohort study.

Created on 18 Aug 2026

Authors

Siyu Yan, Dan Zhou, Yinghao Zhou, Lei Song, Xiaolin Xu, Jiamin Wang, Lin Zhao

Published in

Frontiers in public health. Volume 14. Pages 1887947. Epub Aug 03, 2026.

Abstract

To investigate the current status of early delayed neurocognitive recovery (dNCR) in older adult patients after major orthopedic surgery in China and analyze its influencing factors, providing a reference for early intervention by clinical workers.
Observational cohort study.
A convenience sampling method was used to select patients aged 60 years or older who underwent major orthopedic surgery under general anesthesia at a tertiary hospital in Qingdao, Shandong Province, from September 2025 to June 2026. A general information questionnaire, depression scale, frailty scale, nutrition scale, and sleep quality scale were used to collect data 1 day before surgery. The Beijing version of the Montreal Cognitive Assessment (MoCA) was administered 1 day before surgery and on postoperative day 7 or before discharge (whichever occurred first). Variables with p < 0.2 in the univariate analysis were entered into the binary logistic regression model to identify factors influencing dNCR.
A total of 505 patients were included, of whom 155 (30.69%) developed dNCR. Regression analysis showed that age, sleep disorder, anesthesia time, and stroke history were independent risk factors for postoperative dNCR, and the MoCA score was a protective factor (p < 0.05).
After major orthopedic surgery, dNCR is relatively common in older adult patients. Clinical workers should strengthen early preoperative screening, identify high-risk patients, and provide targeted interventions and cognitive training, so as to improve patient outcomes.

PMID:
42609670
Bibliographic data and abstract were imported from PubMed on 18 Aug 2026.

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