Dataset Information

Long-term Cognitive Trajectory After Total Joint Arthroplasty.

ABSTRACT:

Importance

Individuals with total joint arthroplasty (TJA) have long-term exposure to metal-containing implants; however, whether long-term exposure to artificial implants is associated with cognitive function is unknown.

Objective

To compare long-term cognitive trajectories in individuals with and without TJA.

Design, setting, and participants

This population-based cohort study assessed serial cognitive evaluations of 5550 participants (≥50 years of age) from the Mayo Clinic Study of Aging between November 1, 2004, and December 31, 2020.

Exposures

Total joint arthroplasty of the hip or the knee.

Main outcomes and measures

Linear mixed-effects models were used to compare the annualized rate of change in global and domain-specific cognitive scores in participants with and without TJA, adjusting for age, sex, educational level, apolipoprotein E ε4 carrier status, and cognitive test practice effects.

Results

A total of 5550 participants (mean [SD] age at baseline, 73.04 [10.02] years; 2830 [51.0%] male) were evaluated. A total of 952 participants had undergone at least 1 TJA of the hip (THA, n = 430) or the knee (TKA, n = 626) before or after entry into the cohort. Participants with TJA were older, more likely to be female, and had a higher body mass index than participants without TJA. No difference was observed in the rate of cognitive decline in participants with and without TJA until 80 years of age. A slightly faster cognitive decline at 80 years or older and more than 8 years from surgery was observed (b = -0.03; 95% CI, -0.04 to -0.02). In stratified analyses by surgery type, the faster decline was observed primarily among older participants with TKA (b = -0.04; 95% CI, -0.06 to -0.02).

Conclusions and relevance

In this cohort study, long-term cognitive trajectories in individuals with and without TJA were largely similar except for a slightly faster decline among the oldest patients with TKA; however, the magnitude of difference was small and of unknown clinical significance.

SUBMITTER: Vassilaki M

PROVIDER: S-EPMC9664257 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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Publications

Long-term Cognitive Trajectory After Total Joint Arthroplasty.

Vassilaki Maria M Kremers Walter K WK Machulda Mary M MM Knopman David S DS Petersen Ronald C RC Laporta Mariana L ML Berry Daniel J DJ Lewallen David G DG Maradit Kremers Hilal H

JAMA network open 20221101 11

<h4>Importance</h4>Individuals with total joint arthroplasty (TJA) have long-term exposure to metal-containing implants; however, whether long-term exposure to artificial implants is associated with cognitive function is unknown.<h4>Objective</h4>To compare long-term cognitive trajectories in individuals with and without TJA.<h4>Design, setting, and participants</h4>This population-based cohort study assessed serial cognitive evaluations of 5550 participants (≥50 years of age) from the Mayo Clin ...[more]

PMID: 36374499

Similar Datasets

Project description:BackgroundTo analyze evolution and factors related with greater gains in Health Related Quality of Life (HRQOL) and with a greater probability of exceed their corresponding minimal clinically important differences (MCID) in patients with Osteoarthritis of the knee, undergoing total knee arthroplasty (TKA) at long-term.MethodsData were obtained from two previously recruited multicenter cohorts of patients who underwent TKA in the Basque Country. Patients were follow-up at 6 months and 10 years after surgery. Patients completed specific and generic HRQOL questionnaires plus sociodemographic, and clinical data at 10 years. Associations were analysed using linear and logistic regression models.ResultsA total of 471 patients responded at 10-year follow-up. The multivariable analysis showed that low preoperative HRQOL scores, higher age, higher BMI, some comorbidities and readmissions at 6 months were associated with less gains in HRQOL. Apart from aforementioned, to have a peripheral vascular disease (odd ratio 0.49 (95% CI, 0.24-0.99)), complications (odd ratio 0.31 (95% CI, 0.11-0.91)), and readmissions within 6 months of discharge (odd ratio 2.12 (95% CI, 1.18-3.80)) were associated with a lower probability of exceeding the MCID. The effect sizes (ESs) of changes from baseline to 6 months (range, 1.20-1.96) and to 10 years (range, 1.54-1.99) were large in all dimensions, nevertheless the ESs from 6 months to 10 years were not appreciable for pain (ES = 0.03) or stiffness (ES = 0.09), and small for function (ES = 0.30).ConclusionsLow preoperative HRQOL scores, to be elderly, severe obesity, the presence of some comorbidities -depression and rheumatology disease-, having readmissions or complications and not having rehabilitation of discharge, are good predictors of long-term lower gains in HRQOL. Some other non-registered parameters of the follow-up may also influence those outcomes.Key indexing terms (mesh terms)Health-Related Quality of Life, Knee Arthroplasty, Total, Osteoarthritis.

Dataset Information

Long-term Cognitive Trajectory After Total Joint Arthroplasty.

Importance

Objective

Design, setting, and participants

Exposures

Main outcomes and measures

Results

Conclusions and relevance

Publications

Long-term Cognitive Trajectory After Total Joint Arthroplasty.

Similar Datasets

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