Key result
Surgical and postoperative management of orthopaedic patients with Alzheimer dementia must be demand-matched to the patient's disease severity, life expectancy, and social support system.
Appropriate perioperative and postoperative management of orthopaedic patients with Alzheimer dementia can optimize outcomes and limit disease burden, guided by goals of care.
May guide individualized orthopaedic planning in Alzheimer dementia; leaves open prospective validation before practice change.
Alzheimer disease is a neurologic disorder characterized by the progressive cognitive decline. As the population continues to age, orthopaedic surgeons need to become familiar with surgical and nonsurgical treatment considerations in this complex population. Despite the advances in geriatric and dementia care, surgical and postoperative management of both elective and emergent surgery remain complex and controversial in this patient population. Appropriate perioperative and postoperative management can optimize outcomes, and the management can significantly affect the quality of life of patient and caregiver and limit disease burden. Any treatment decision should be guided first and foremost by the goals of care as agreed between the surgeon, other providers, and family. Surgical management must be demand matched to the patient accounting for the severity of disease, life expectancy, and the social support system. The authors conducted a literature review of Alzheimer dementia care in orthopaedic patients via a Pubmed search of relevant articles published since 1980.
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Aneja et al. (2018) conducted a review in Alzheimer dementia in orthopaedic patients. Surgical and nonsurgical treatment was evaluated. Surgical and postoperative management of orthopaedic patients with Alzheimer dementia must be demand-matched to the patient's disease severity, life expectancy, and social support system.
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