Statins and Senior Surgery: A Surprising Link to Delirium Risks Revealed

Steer clear of statins before surgery: The hidden risk for seniors

If you or a loved one over 70 years old is scheduled for surgery, it’s crucial to pay attention to the medications taken in the three months leading up to the big day. Specifically, statin drugs should be approached with caution. Research conducted by Ontario’s Institute for Clinical Evaluative Sciences (ICES) has found that seniors taking statins before surgery are at a 28 percent increased risk of postoperative delirium.

Delirium: What it is and why it matters

Delirium is a disturbance in mental abilities that results in confused thinking and reduced awareness of the environment. It may be accompanied by rapid or dramatic shifts in mood or behavior, disorientation, fear, agitation, hallucinations, or delusions. While this condition may be temporary and reversible, it can cause significant distress to patients and their families.

More importantly, delirium has serious implications for a patient’s recovery process. It can lead to a longer hospital stay, an increased need for intensive care, and disruption or delay in receiving essential healthcare. In some cases, it can even result in increased mortality.

ICE’s researchers highlight the significance of their findings: “Our results suggest that this association was more than a coincidence, particularly among patients who received higher doses of statins and had longer duration noncardiac surgeries.”

How statins may contribute to delirium

Statins are widely prescribed medications that help lower the levels of low-density lipoprotein (LDL) cholesterol, commonly known as “bad” cholesterol, in the blood. They are essential in the management of high cholesterol, which is a major risk factor for cardiovascular diseases. However, their use in seniors approaching surgery may have unintended consequences.

While the exact mechanism behind the connection between statins and the development of delirium is unclear, there are a few theories. One possible explanation is that statins may affect brain function by interfering with cholesterol synthesis in the brain. Cholesterol is essential for the production of neurotransmitters like serotonin and dopamine, which play a critical role in maintaining mood, memory, and cognitive function.

Another theory is that the use of statins may cause a decrease in the production of coenzyme Q10 (CoQ10), a substance that helps provide energy to cells and has antioxidant properties. A deficiency in CoQ10 has been linked to a decline in cognitive function and an increased risk of delirium.

Finally, some researchers suggest that statin-induced muscle damage, known as statin-associated myopathy, may contribute to the development of delirium through the release of muscle proteins and the subsequent triggering of a systemic inflammatory response.

Weighing the risks

Given the potential implications of statin use before surgery, it’s essential for senior patients and their healthcare providers to carefully consider the risks and benefits of these medications during the preoperative period. This may involve a thorough assessment of the patient’s overall health, cholesterol levels, and cardiovascular risk factors, as well as a review of their current medications to identify any drug interactions or side effects that may increase the risk of delirium.

In some cases, patients may be advised to temporarily discontinue the use of statins before surgery to minimize the risk of postoperative delirium. Alternatively, the dose or type of statin drug may be adjusted to reduce the likelihood of adverse effects. Ultimately, the decision should be based on a personalized evaluation of the patient’s individual needs and circumstances, taking into consideration their age, comorbidities, and surgical complexity.

Tips for reducing the risk of delirium

In addition to addressing the potential risks associated with statin use, there are several other strategies seniors and their families can employ to reduce the risk of delirium following surgery:

  1. Maintain a consistent daily routine. A predictable routine that includes regular sleep and wake times, balanced meals, and daily exercise can help minimize stress and promote overall well-being.

  2. Stay mentally engaged. Encourage participation in mentally stimulating activities such as reading, crossword puzzles, and brain games to help maintain cognitive function.

  3. Promote optimal nutrition. A balanced diet that includes foods rich in antioxidants, vitamins, and minerals can support brain health and cognitive function.

  4. Encourage social interaction. Engaging in regular social activities can help improve mood and mental function.

  5. Manage medications carefully. Review all medications – both prescription and over-the-counter – with a healthcare professional to ensure they’re appropriate and safe for use and discuss any potential side effects or interactions.

By taking a proactive approach to managing the risks associated with statins and other contributing factors, seniors can minimize the likelihood of developing delirium during their recovery period and ensure a smoother, more successful surgical outcome.