'Mental Resilience' May Give Holocaust Survivors an Edge After Surgery

June 6, 2022
By Robert Preidt HealthDay Reporter

Holocaust survivors have a lower risk of delirium after surgery than others their age, and a new study suggests it may owe to mental resilience developed in response to their horrific experiences.

"Given that Holocaust survivors are at increased risk of a range of physical and psychological conditions, we were surprised to find that they seem to have a lower risk of post-operative delirium," said study leader Dr. Yotam Weiss. He is with the department of anesthesiology and intensive care at Tel Aviv Medical Center in Israel.

"As a grandson to survivors, the first thing … that came to mind was 'resilience' - the ability to adapt positively to adversity or to recover readily from adversity," Weiss said.

Weiss presented the findings at a meeting of the European Society of Anaesthesiology and Intensive Care, held online and in Milan, Italy, June 4 to 6. Research presented at meetings should be considered preliminary until published in a peer-reviewed journal.

The researchers noted that delirium - confusion and sudden and severe problems with thinking, memory and awareness - is the most common complication after surgery in older people.

Though often short-lived, it can result in a longer hospital stay and patients being discharged to a rehabilitation center instead of returning home.

Previous research has found that Holocaust survivors tend to have poorer physical and mental health than others in their age group, but little was known about their risk of delirium after surgery.

The learn more, Israeli researchers studied more than 1,200 patients aged 75 and older. They had a variety of elective procedures, from biopsies and cataract surgery to hip replacements, cancer operations, and thoracic and vascular procedures at Tel-Aviv Medical Center between January 2020 and July 2021.

In all, 26% of patients were Holocaust survivors with an average age of 82, the new study found. The average age of non-Holocaust survivors was 80.

The two groups had similar rates of delirium after surgery - 14% in Holocaust survivors and 16% in others. But when researchers accounted for known risk factors such as age, mental impairment and type of surgery, they concluded that the Holocaust survivors were 40% less likely to develop delirium than others.

Holocaust survivors were twice as likely to fall while in the hospital (4% versus 2%) but there was no difference between the two groups in rates of adverse outcomes such as unplanned intensive care admission, discharge to a facility instead of home, having a stroke or heart attack within three months of surgery, or death within a year.

Weiss noted that early studies of Holocaust survivors described "survivor syndrome" and "concentration camp syndrome," emphasizing the negative mental aspects of their experiences. But later studies characterize them as exhibiting "survivorship and resilience," he added.

"We can only assume that these traits exist in those that have survived the Holocaust and reached old age," but this is "only a hypothesis, and testing for resilience pre-operatively in a follow-up study might shed further light on our finding and also expand our knowledge of delirium," Weiss said in a meeting news release.

He said information like that from this study can help tailor their care.

More information

There's more on delirium at HealthinAging.org.

SOURCE: European Society of Anaesthesiology and Intensive Care, news release, June 2, 2022

Anesthesia Surgery: Misc.Neurology Psychology / Mental Health: Misc.