Effects of Cholinesterase Inhibitors on Postoperative Outcomes of Older Adults With Dementia Undergoing Hip Fracture Surgery

Initiation of Antidepressant Medication After Hip Fracture in Community-Dwelling Older Adults

“…These databases have been used previously to describe outcomes related to hip fractures. 23,24 These data sets were linked using unique encoded identifiers and analyzed at the Institute for Clinical Evaluative Sciences in Toronto, Ontario, Canada.…”

Postoperative Medical Complications Associated with Anesthesia in Older Adults with Dementia

“…Transfers to intensive care units (ICUs) in the 7 days after surgery were reported, using a previously described approach. 25,35 Finally, length of stay for the index hospitalization was determined for all individuals.…”

“…In‐hospital complications that occurred during the index admission and those that required a hospital readmission or ED visit within 30 days of surgery were included. Transfers to intensive care units (ICUs) in the 7 days after surgery were reported, using a previously described approach . Finally, length of stay for the index hospitalization was determined for all individuals.…”

Guidelines for the peri‐operative care of people with dementia

“…They are used to offer temporary and modest relief of cognitive symptoms in people with mild to moderate dementia. Cholinesterase inhibitors interact with muscle relaxants, prolonging the effects of depolarising neuromuscular blocking drugs (suxamethonium), and decrease or reverse the effects of non‐depolarising neuromuscular blocking drugs . Larger doses of non‐depolarising muscle relaxants may be required to achieve satisfactory paralysis.…”

“…However, from a neuropsychiatric perspective, discontinuation risks worsening cognitive function, and suggests the risk of interaction should be managed, as it would be during emergency surgery. Even then, cholinesterase inhibitor use during emergency (hip) surgery does not appear to be associated with an increased risk of postoperative complications in general, and respiratory complications more specifically . Cholinesterase inhibitors should certainly be continued before elective surgery when the likelihood of neuromuscular blocking agent administration is low.…”