Anaesthesia Cognition Evaluation (ACE) Study

据了解，55岁以上的患者中约有10%在手术和麻醉后3个月出现认知和思维困难。澳大利亚每年进行超过200万例涉及麻醉的手术，越来越多的患者是老年人，因此面临手术后认知能力下降的风险。我们有初步的数据显示，术前认知功能有轻微变化的人（被称为轻度认知障碍）在麻醉和手术后很容易出现进一步的认知衰退。为了探讨术前认知功能和术后认知能力下降之间的关系，我们计划测量选择性髋关节置换术患者的认知能力。这是通过要求患者完成一系列标准的认知测试来完成的。然后，我们将能够识别那些在手术前已经有轻度认知障碍的患者，通过手术后的反复测试，将能够证明术前认知状态是否是术后认知功能障碍的决定因素。该研究的主要目的是测试65岁以上接受全髋关节置换术的患者术前认知障碍是否会导致术后认知障碍。该研究还将确定该患者组术前轻度认知功能障碍的患病率和术后认知功能障碍的程度。本研究将探讨术前认知状态与术后认知功能障碍的关系，为术后认知功能障碍的发生率、自然病史及危险因素提供信息。这项工作将使进一步的研究能够分离特定的致病因素，并确定治疗和预防策略。

It is known that about 10% of patients over the age of 55 have difficulty with cognition and thinking 3 months after surgery and anaesthesia. Over 2 million operations involving anaesthesia are administered in Australia every year and increasingly the patients are elderly and thus exposed to the risk of cognitive decline after surgery. We have preliminary data showing that people who have mild changes in cognitive function before the surgery (known as mild cognitive impairment) are susceptible to further cognitive decline after anaesthesia and surgery. In order to explore the relationship between preoperative cognitive function and postoperative cognitive decline we plan to measure cognition in patients scheduled for elective hip replacement surgery. This is done by asking patients to complete a standard battery of cognitive tests. We will be then able to identify those patients who already have mild cognitive impairment before surgery and by repeated testing after the operation will be able to demonstrate if preoperative cognitive status is a determinant of postoperative cognitive dysfunction. The primary aim of the research is to test whether cognitive impairment before surgery leads to cognitive deficit after surgery in patients over the age of 65 undergoing total hip replacement surgery. The study will also establish the prevalence of pre-operative mild cognitive impairment and the magnitude of postoperative cognitive dysfunction after surgery in this patient group. The study will explore the relationship between preoperative cognitive status and postoperative cognitive deficit , providing information about the incidence, natural history and risk factors of postoperative cognitive deficit. This work will enable further research to isolate specific causative factors and identify therapeutic and prophylactic strategies.