Lumbar Puncture Seems to Be Safe and Practical in Oldest-Old Patients: A Protocol From a Memory Center

Abstract

PurposePhysicians may hesitate to perform lumbar puncture (LP) with advancing age, particularly in daily practice in those aged 80 years or older. This study aimed to evaluate the characteristics and complications of LP in the oldest-old.MethodsThe medical records of all the patients who underwent LP in a geriatrics inpatient memory clinic were retrospectively reviewed with a specified protocol. As well as demographics, indication for LP, position during the procedure, the total number of LP attempts, the volume of CSF removed, post-LP headache (PLPH), and post-LP back pain at the LP site (PLPBP) were also obtained from the patients' files. The patients were divided into two groups based on their ages as older adults and oldest-old adults.ResultsIn this study, a total of 202 LPs were included, of which 39.6% were performed in those aged >= 80. PLPH was detected in 6.9% and PLPBP in 7.4% of all our patients, while the rates were 7.5% and 6.3% in the oldest-old group.The frequency of PLPH and PLPBP, the number of traumatic LP procedures, and repeated LP attempts were similar. between the groups. In regression analysis, only the medical history of headache was correlated with PLPH, as well as nonspecific headache, and intracranial hypotension. PLPBP was associated with the number of LP attempts (>= 3).ConclusionIn the oldest old, lumbar puncture is as safe as in younger-older adults when it is performed in experienced geriatric clinics with the specified protocol.