Associations of dyslipidaemia and lipid-lowering treatment with risk of postoperative cognitive dysfunction: a systematic review and meta-analysis

BackgroundLipid imbalance is linked to age-related cognitive impairment, but its role in postoperative cognitive dysfunction (POCD) is unknown. Here, we present a systematic review and meta-analysis on dyslipidaemia, lipid-lowering treatment and POCD risk.MethodsPubMed, Ovid SP and Cochrane database...

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Vydáno v:Journal of epidemiology and community health (1979) Ročník 72; číslo 6; s. 499 - 506
Hlavní autoři: Feinkohl, Insa, Winterer, Georg, Pischon, Tobias
Médium: Journal Article
Jazyk:angličtina
Vydáno: England BMJ 01.06.2018
BMJ Publishing Group LTD
Témata:
Age
Aging
Apolipoproteins
Cholesterol
Cognitive ability
Dementia
Dyslipidemia
Epidemiology
Estimates
Lipids
Lipoproteins
Longitudinal studies
Medical screening
Meta-analysis
Metabolic disorders
Review
Risk assessment
Statins
Surgery
Systematic review
Triglycerides
cognition
meta analysis
lipids
ISSN:0143-005X, 1470-2738, 1470-2738
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Shrnutí:BackgroundLipid imbalance is linked to age-related cognitive impairment, but its role in postoperative cognitive dysfunction (POCD) is unknown. Here, we present a systematic review and meta-analysis on dyslipidaemia, lipid-lowering treatment and POCD risk.MethodsPubMed, Ovid SP and Cochrane databases were searched for longitudinal studies that reported on associations of any measure of dyslipidaemia and/or lipid-lowering treatment with POCD as relative risks (RRs) or ORs. Fixed-effects inverse variance models were used to combine effects.ResultsOf 205 articles identified in the search, 17 studies on 2725 patients (grand mean age 67 years; mean age range 61–71 years) with follow-up periods of 1 day to 4 years (median 7 days; IQR 1–68 days) were included. Studies focused almost exclusively on hypercholesterolaemia as a measure of dyslipidaemia and on statins as lipid-lowering treatment. Across 12 studies on hypercholesterolaemia, we found no association with POCD risk (RR 0.93; 95% CI 0.80 to 1.08; P=0.34). Statin use before surgery was associated with a reduced POCD risk across eight studies (RR 0.81; 95% CI 0.67 to 0.98; P=0.03), but data on treatment duration were lacking.ConclusionStatin users appear to be at reduced risk of POCD although hypercholesterolaemia per se may not be associated with POCD risk. Trial studies are needed to evaluate the usefulness of statins in POCD prevention.
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ISSN:0143-005X
1470-2738
1470-2738
DOI:10.1136/jech-2017-210338