THE SEARCH FOR SOLUTIONS TO PND
THREE EASILY ACCESSIBLE SOURCES OF TRUSTWORTHY PND INFORMATION
A JOURNALIST AND TWO WEB SITES
Since acquiring the most recent information available prior to surgery is imperative, this section is designed to assist you if you are unfamiliar with healthcare research to easily learn how to access current PND information whenever needed. You can tailor the research information to focus on what is personally necessary to make decisions about care prior to, during, and after surgery to hopefully avoid or at least cope with the possible negative neurocognitive surgical consequences.
A Leading Trustworthy Journalist On Older Adults And Surgery
Journalist Judith Graham founded the core topic Aging for the Association of Health Care Journalists, and her pioneering work has been widely published by notable media for many years. She has written superb pieces on a wide range of health care topics important to older adults. Some are relevant to this PND report. For ease of doing the first part of your own research by reading her pertinent articles. On this site you will find her 2018 article, “What We Know And Don’t Know About Memory Loss After Surgery” and her 2019 report, “The Talk Seniors Need to Have with Doctors Before Surgery.” There is also a November 2022 article, “Should Older Seniors Risk Major Surgery? New Research Offers Guidance.” Due to many requests from readers for more on the topic, it is followed quickly by the January 2023 article, “Weighing Risks of a Major Surgery: 7 Questions Older Americans Should Ask Their Surgeon.”
On this same site, in addition to these extraordinary PND-relevant reports, older adults and their care partners have an excellent opportunity to benefit from her many other contributions to improving health status and the ability to make thoughtful decisions when important healthcare issues arise.
Two Leading Trustworthy PND Information Web Sites
Following are the links to access two excellent sites for accurate information. The American Society of Anesthesiologists (ASA) is a major organization that has taken the lead in supplying specialized clinical information and research about the many aspects of PND care. The American Geriatrics Society (AGS) site also provides important information. The links provided for you next feature the written work and videos of researchers and clinicians who have devoted their careers to understanding and lessening the impact of PND on the lives of older adults.
The American Society of Anesthesiologists (ASA) is frequently utilized as the provider of excellent information from anesthesiologists. It currently offers an Anesthesia 101 section about the personal risks of receiving anesthesia that includes suffering PND. There is also a Preparing for Surgery section that assists people to identify their personal risk factors and a Preparation for Surgery Checklist.
Also helpful is the ASA’s Brain Health Initiative site. It is located in the For Patients section and offers a wealth of information about optimizing cognitive recovery after surgery, especially if age 65 or over. In the Publications News & Videos section there are conference videos, webinars, and interviews available relevant to PND topics.
The ASA also has a YouTube channel where more informational videos are available at https://www.youtube.com/results?search_query=american+society+of+anesthesiologists.
All ASA sites also may be useful if you are urging and supporting a hospital or surgical center to create a healthcare team it calls a Perioperative Surgical Home. Such a team includes expert research-based preoperative, intraoperative, postoperative, and long-term recovery care, especially for those most at risk for the damages to quality of life inherent in experiencing PND. They are also useful for providing an initial over-view of PND for any healthcare team serving older adults. The American Geriatrics Society (AGS) offers valuable expert information on topics such as informed consent, postoperative delirium, dementia, advance directives, and assisted living through its foundation’s site at https://www.healthinaging.org/.
ANOTHER READILY AVAILABLE INFORMATION SOURCE:
USING THE PubMed SITE: DOING KEYWORD SEARCHES FOR UPDATING PND RESEARCH INFORMATION
This country’s PubMed site is the one most utilized by those of us in healthcare research for finding global research studies on any biomedical topic. It is free to the public and highly regulated for accuracy. Take great care when using unregulated search engines like Google Scholar or other developing new generative AI search engines like ChatGPT for information on PND. Currently, they hold the possibility of retrieving information that may be to some degree inaccurate or misleading. Open AI, the company that is developing ChatGPT, warns against using it for information on serious medical conditions and PND is in that category.
PubMed is at: https://pubmed.ncbi.nlm.nih.gov
Here are instructions on using the site to easily access vital information: Once on the PubMed site, you may keep your search as simple as possible by retrieving recent studies that summarize other studies. Just type the word “review” (no quotation marks needed) and the keyword(s) most relevant to your situation into the search box to retrieve the abstracts of review studies. On the list retrieved, adjust the dates of study abstracts to the past few years by using the timeline sliding date selector. Starting with the recent review studies oDers you an overview of the research on that keyword topic.
When you find any study you wish to read in detail after reading its abstract, you will often see on the right the sign that a “FREE Full text” is available. Clicking on that box brings up the full text and you may then choose a PDF or PubReader format to read or print. When reading a review study, you are likely to be able to determine the specific studies it cites that are most relevant to your personal decision-making concerns. Then use the same process to read those studies. If you need any additional guidance, open the “User Guide” near the search field box.
Keywords useful for PND PubMed searches for PND overview information: review, perioperative brain health, perioperative neurocognitive disorders pnd, postoperative delirium, delayed neurocognitive recovery, postoperative cognitive dysfunction, perioperative care of geriatric patient, geriatric anesthesia. Other PubMed keywords are listed later appropriate to the content of the sections of this paper on suggested care for older adults during each of the four potential periods of the perioperative experience.
An Example of a Helpful Study Found by Utilizing the PubMed Research Process
As noted, this research report is written as a guide for older adults who may not be familiar with research on PND. It is distilled from a recent review of over 150 studies and offers the most frequently mentioned concepts from studies in general summary terms rather than quoting similar suggestions from each study individually as done for publication.
Here, however, is a specific research study example for you to read since it is an unusually well done 2022 review study entitled, Mitigation of perioperative neurocognitive disorders: A holistic approach by noted PND experts Seyed A. Safavynia, Peter A. Goldstein, and Lisbeth A. Evered. See page 11 of the study for a valuable timeline for the brain-specific portion of the Enhanced Recovery After Surgery (ERAS) protocol. The study is an excellent example of the breadth and depth of a review paper that combines both clinical and laboratory data to inform possible treatment ideas. It also supports closely examining the vital question of whether surgery should be undertaken, making it holistic in its scope. The link for this study is: https://pubmed.ncbi.nlm.nih.gov/35966792/.
You may want to send the above link to every health professional you see for perioperative care or take a printed copy to give them in person to read before seeing you. It can serve as a valuable guide for talking with them about the full warnings for and care of possible PND outcomes that would apply to you. That discussion also may include the possibility of selecting non-surgical treatment alternatives. If reading this guide to the research process in 2024 or 2025, consider the above study still relevant. If reading this guide later than 2025, check for updates to the study or perform a PubMed search using the names of researchers who authored the above study or search for a review study of its same nature published in the past year or two.
As will be evident, many of the following perioperative care notes also can be found by reading the above review study. Please understand that the following sections on the care of someone considering surgery, preparing for it, and needing postoperative PND care simply cannot be entirely comprehensive. Fortunately, new ideas will emerge, and you can expand and update your knowledge of effective approaches to quality care by using the web sites and research methods described so far.