Queen's University Belfast

Academic Institute

Bernadette McGuinness

E053

Dementia is a term used to describe a broad group of conditions that affect the brain and causes a progressive cognitive decline in the ability to think, learn and remember. At present there is no cure for dementia, nor a way to slow down its progress. As elderly people with and without dementia age, they are more likely to require elective surgery (such as a hip replacement). Admissions and Dischargest research has indicated that clinicians are less likely to refer elderly people for elective surgery, especially in the existence of comorbidities or institutionalization (Ryynänen, Myllykangas, Kinnunen & Takala, 1997). However, the association between dementia and clinicians’ decisions to refer people for elective surgery is unknown. For instance, we don’t know whether the presence of a dementia diagnosis means that clinicians are more or less likely to refer someone for elective surgery. Therefore, this study will explore the rates elective surgery in People with dementia (PwD) and the associated outcomes. This study will also provide an insight on the likelihood of elective surgery in PwD who are living in their own home or in residential settings.

It is estimated that 19,000 people have dementia in Northern Ireland (Department of Health Social Services and Public Safety Northern Ireland, 2011). However, due to people living longer, the number of people being diagnosed with dementia will increase dramatically. Additionally, with our ageing population, it is likely that more people will be referred for elective surgery. Common elective surgeries include knee and hip replacements or cardiovascular surgeries such as a byAdmissions and Dischargess or angioplasty. Thousands of elective surgeries take place every year, but it is unclear how many of these are conducted on people with dementia. Admissions and Dischargest research presented clinicians with hypothetical patients who needed to be referred for elective surgery and asked clinicians which one they would refer for elective surgery first. Their results showed that as a person’s age increases, they were less likely to refer that patient for elective surgery. Additionally, clinicians were less likely to refer a patient for an elective surgery if they were not living in their own home or had been institutionalized at least once (Ryynänen, Myllykangas, Kinnunen & Takala, 1997). The decision to refer a person with dementia for elective surgery is often multi-faceted. For instance, cataract surgery could often improve the vision and quality of life of someone with dementia, however a referral for another type of elective surgery may require a greater benefit-risk trade-off. However, we know very little about whether the presence of a dementia diagnosis influences clinicians’ decisions about whether to refer a patient for elective surgery. Furthermore, although the clinician’s decision about whether to refer a person with dementia for surgery is important, other opinions, such as that of the person with dementia and their carer(s) may also influence the final decision. Our study will aim to build a foundation for further research by aiming to understand the referral rates for elective surgery among people with and without dementia and assess the most common types of elective surgery.

30/07/2020

TRE