Cognitive Changes and Retirement among Senior Surgeons (CCRASS): Results from the CCRASS Study

BACKGROUND: Because individuals age cognitively at different rates, there is considerable interest in ways to assure that older surgeons have the physical and mental stamina, coordination, reaction time, and judgment to provide appropriate care. To clarify potential relationships between cognitive changes related to aging, the decision to retire, and changes in patterns of surgical practice, this study aimed to identify specific parameters of cognitive change among senior surgeons. STUDY DESIGN: Computerized cognitive tasks measuring sustained attention, reaction time, visual learning, and memory were administered to 359 surgeons at the annual meetings of the American College of Surgeons over a 6-year period. A self-report survey was also administered to assess subjective cognitive changes and the status of surgical practice and retirement decisions. RESULTS: Expected age-related cognitive decline was demonstrated on all measures, although measured reaction time was notably better than age-appropriate norms. There was a marked relationship between self-reported subjective cognitive change and retirement status, but not to changes in surgical practice. There was no notable relationship, however, between subjective cognitive change and objective cognitive measures. There were marked relationships between age and retirement decision or status and between age and changes in surgical practice. CONCLUSIONS: These results suggest that although self-perceived cognitive changes play a role in the decision to retire, they are not related to objective measures of cognitive change, and are not reliable in the decision to retire. The development of readily accessible measures of cognitive changes related to aging may serve to assist decisions either to continue surgical practice or to retire.