{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:17:04Z","timestamp":1788308224110,"version":"build-2803163510"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>As the population ages, meningiomas are increasingly encountered in older patients, yet longitudinal functional outcomes following surgery across age groups remain incompletely characterized. This study evaluated age-related differences in clinical and tumor characteristics, functional trajectory, and surgical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This was a retrospective cohort study of 396 consecutive patients who underwent surgery for intracranial meningiomas at a single academic center between January 2023 and September 2025. Patients were stratified into 5 age groups (&lt; 65, 65\u201369, 70\u201374, 75\u201379, and \u2265 80 years). Neurological deficits and Karnofsky Performance Status (KPS) were assessed preoperatively, at discharge, and at last follow-up. Logistic regression analyses identified predictors of prolonged length of stay (LOS) (&gt; 5 days) and poor functional outcome at discharge (KPS &lt; 80).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Older patients presented with greater comorbidity burden, larger tumors, and lower preoperative KPS (all p &lt; 0.05), while gross-total resection was achieved at comparable rates across all age groups (p = 0.504). A clinically meaningful inflection point was observed around age 75 years, with KPS &lt; 80 at discharge rising from 7.4% and 9.7% in the &lt; 65-year and 70- to 74-year subgroups and to 36.2% and 57.1% in the 75- to 79-year and \u2265 80-year subgroups (p &lt; 0.001), and median LOS increased from 4 days in the younger groups to 9 and 7 days in the 75- to 79-year and \u2265 80-year groups (p &lt; 0.001). However, recovery rates among patients who experienced functional decline at discharge were comparable across age strata. On multivariable analysis, independent predictors of prolonged LOS were age \u2265 75 years (OR 2.31, p = 0.019), diabetes mellitus (OR 2.85, p = 0.004), posterior fossa location (OR 2.1, p = 0.008), tumor diameter (OR 1.33, p &lt; 0.001), postoperative edema (OR 2.58, p = 0.015), and neurosurgical complications (OR 3.18, p = 0.002). Independent predictors of poor functional outcome at discharge were age \u2265 75 years (OR 5.84, p &lt; 0.001), lower preoperative KPS (OR 2.8, p &lt; 0.001), posterior fossa location (OR 3.72, p = 0.003), neurosurgical complications (OR 3.56, p = 0.008), and recurrent meningioma (OR 2.89, p = 0.025). Among 70 endoscopic endonasal approach patients, higher preoperative deficit burden and subtotal resection rates were observed compared to open craniotomy, though overall functional outcomes were comparable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Surgical risk in meningioma resection increases from age 75 years onwards, yet recovery capacity following initial functional decline remains similar across all age groups. Preoperative functional status, tumor location, comorbidity burden, and recurrence history should guide surgical decision-making rather than age alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.6.focus26264","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:01:14Z","timestamp":1787702474000},"page":"E11","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal functional trajectory and surgical outcomes after intracranial meningioma resection: implications for surgical decision-making in older patients"],"prefix":"10.3171","volume":"61","author":[{"given":"Neslihan Nisa","family":"Gecici","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake","family":"Littman","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Habib","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walaa","family":"Hamza","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maged T.","family":"Ghoche","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rivka R.","family":"Colen","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalil G.","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and Department of Otolaryngology, NYU Langone, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios A.","family":"Zenonos","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal O.","family":"Zinn","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"Supplement_6","key":"b1","series-title":"Neuro Oncol","first-page":"vi1","article-title":"CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2017-2021","volume":"26","author":"Price M","year":"2024","unstructured":"Price M, Ballard C, Benedetti J,  CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2017-2021. Neuro Oncol. 2024;26(Supplement_6):vi1\u2013vi85. doi:10.1093\/neuonc\/noae145"},{"issue":"4","key":"b2","series-title":"J Neurosurg","first-page":"1201","article-title":"Surgery for meningioma in the elderly and long-term survival: comparison with an age- and sex-matched general population and with younger patients","volume":"126","author":"Brokinkel B","year":"2017","unstructured":"Brokinkel B, Holling M, Spille DC,  Surgery for meningioma in the elderly and long-term survival: comparison with an age- and sex-matched general population and with younger patients. J Neurosurg. 2017;126(4):1201\u20131211. doi:10.3171\/2016.2.JNS152611"},{"issue":"21","key":"b3","series-title":"Future Oncol","first-page":"2161","article-title":"An overview of meningiomas","volume":"14","author":"Buerki RA","year":"2018","unstructured":"Buerki RA, Horbinski CM, Kruser T, Horowitz PM, James CD, Lukas RV. An overview of meningiomas. Future Oncol. 2018;14(21):2161\u20132177. doi:10.2217\/fon-2018-0006"},{"issue":"10","key":"b4","series-title":"Neuro Oncol","first-page":"2738","article-title":"Years of life lost due to central nervous system tumor subtypes in the United States","volume":"27","author":"Gerstl JVE","year":"2025","unstructured":"Gerstl JVE, Price M, Bernstock JD,  Years of life lost due to central nervous system tumor subtypes in the United States. Neuro Oncol. 2025;27(10):2738\u20132746. doi:10.1093\/neuonc\/noaf142"},{"issue":"11","key":"b5","series-title":"Neuro Oncol","first-page":"1821","article-title":"EANO guideline on the diagnosis and management of meningiomas","volume":"23","author":"Goldbrunner R","year":"2021","unstructured":"Goldbrunner R, Stavrinou P, Jenkinson MD,  EANO guideline on the diagnosis and management of meningiomas. Neuro Oncol. 2021;23(11):1821\u20131834. doi:10.1093\/neuonc\/noab150"},{"issue":"6","key":"b6","series-title":"Neurooncol Pract","first-page":"438","article-title":"A prospective study of the natural history of incidental meningioma\u2013Hold your horses!","volume":"6","author":"Behbahani M","year":"2019","unstructured":"Behbahani M, Skeie GO, Eide GE, Hausken A, Lund-Johansen M, Skeie BS. A prospective study of the natural history of incidental meningioma\u2013Hold your horses!. Neurooncol Pract. 2019;6(6):438\u2013450. doi:10.1093\/nop\/npz011"},{"key":"b7","series-title":"World Neurosurg","first-page":"e350","article-title":"Elderly patients with intracranial meningioma: surgical considerations in 228 patients with a comprehensive analysis of the literature","volume":"132","author":"Ek\u015fi M\u015e","year":"2019","unstructured":"Ek\u015fi M\u015e, Canbolat \u00c7, Akba\u015f A,  Elderly patients with intracranial meningioma: surgical considerations in 228 patients with a comprehensive analysis of the literature. World Neurosurg. 2019;132:e350\u2013e365. doi:10.1016\/j.wneu.2019.08.150"},{"issue":"2","key":"b8","series-title":"Diagnostics (Basel)","first-page":"351","article-title":"Intracranial meningioma in elderly patients. Retrospective multicentric risk and surgical factors study of morbidity and mortality","volume":"12","author":"Armocida D","year":"2022","unstructured":"Armocida D, Arcidiacono UA, Palmieri M,  Intracranial meningioma in elderly patients. Retrospective multicentric risk and surgical factors study of morbidity and mortality. Diagnostics (Basel). 2022;12(2):351. doi:10.3390\/diagnostics12020351"},{"issue":"3","key":"b9","series-title":"Br J Neurosurg","first-page":"303","article-title":"Outcome of elderly patients undergoing intracranial meningioma resection\u2013a systematic review and meta-analysis","volume":"28","author":"Poon MT","year":"2014","unstructured":"Poon MT, Fung LH, Pu JK, Leung GK. Outcome of elderly patients undergoing intracranial meningioma resection\u2013a systematic review and meta-analysis. Br J Neurosurg. 2014;28(3):303\u2013309. doi:10.3109\/02688697.2013.841857"},{"issue":"4","key":"b10","series-title":"Neurosurg Focus","first-page":"E16","article-title":"Frailty predicts worse outcomes after intracranial meningioma surgery irrespective of existing prognostic factors","volume":"49","author":"Theriault BC","year":"2020","unstructured":"Theriault BC, Pazniokas J, Adkoli AS,  Frailty predicts worse outcomes after intracranial meningioma surgery irrespective of existing prognostic factors. Neurosurg Focus. 2020;49(4):E16. doi:10.3171\/2020.7.FOCUS20324"},{"issue":"4","key":"b11","series-title":"Neurosurg Focus","first-page":"E18","article-title":"Resection of meningiomas in octogenarians: a comparison with a younger geriatric population","volume":"49","author":"Corniola MV","year":"2020","unstructured":"Corniola MV, Lem\u00e9e JM, Meling TR. Resection of meningiomas in octogenarians: a comparison with a younger geriatric population. Neurosurg Focus. 2020;49(4):E18. doi:10.3171\/2020.7.FOCUS20306"},{"issue":"1","key":"b12","series-title":"Sci Rep","first-page":"11454","article-title":"Mortality of surgically treated 80-year-old or older intracranial meningioma patients in comparison to matched general population","volume":"11","author":"Rautalin I","year":"2021","unstructured":"Rautalin I, Schwartz C, Niemel\u00e4 M, Korja M. Mortality of surgically treated 80-year-old or older intracranial meningioma patients in comparison to matched general population. Sci Rep. 2021;11(1):11454. doi:10.1038\/s41598-021-90842-y"},{"issue":"4","key":"b13","series-title":"Neurosurg Focus","first-page":"E17","article-title":"Minimally invasive surgical treatment of intracranial meningiomas in elderly patients (\u2265 65 years): outcomes, readmissions, and tumor control","volume":"49","author":"Thakur JD","year":"2020","unstructured":"Thakur JD, Mallari RJ, Corlin A,  Minimally invasive surgical treatment of intracranial meningiomas in elderly patients (\u2265 65 years): outcomes, readmissions, and tumor control. Neurosurg Focus. 2020;49(4):E17. doi:10.3171\/2020.7.FOCUS20515"},{"issue":"6","key":"b14","series-title":"Neurosurg Focus","first-page":"E19","article-title":"Incidental meningiomas","volume":"31","author":"Chamoun R","year":"2011","unstructured":"Chamoun R, Krisht KM, Couldwell WT. Incidental meningiomas. Neurosurg Focus. 2011;31(6):E19. doi:10.3171\/2011.9.FOCUS11220"},{"issue":"5","key":"b15","series-title":"J Neurosurg","first-page":"1250","article-title":"The natural history of intracranial meningiomas","volume":"114","author":"Oya S","year":"2011","unstructured":"Oya S, Kim SH, Sade B, Lee JH. The natural history of intracranial meningiomas. J Neurosurg. 2011;114(5):1250\u20131256. doi:10.3171\/2010.12.JNS101623"},{"issue":"3","key":"b16","series-title":"Neurosurgery","first-page":"543","article-title":"The 35-year evolution of stereotactic radiosurgery for meningiomas","volume":"98","author":"Wei CZ","year":"2026","unstructured":"Wei CZ, Niranjan A, Deng H,  The 35-year evolution of stereotactic radiosurgery for meningiomas. Neurosurgery. 2026;98(3):543\u2013551. doi:10.1227\/neu.0000000000003702"},{"issue":"1","key":"b17","series-title":"Neurosurgery","first-page":"53","article-title":"Radiosurgery as definitive management of intracranial meningiomas","volume":"62","author":"Kondziolka D","year":"2008","unstructured":"Kondziolka D, Mathieu D, Lunsford LD,  Radiosurgery as definitive management of intracranial meningiomas. Neurosurgery. 2008;62(1):53\u201358. doi:10.1227\/01.NEU.0000311061.72626.0D"},{"issue":"9","key":"b18","series-title":"Acta Neurochir (Wien)","first-page":"1549","article-title":"Intracranial meningioma surgery in the elderly (over 65 years): prognostic factors and outcome","volume":"157","author":"Chen ZY","year":"2015","unstructured":"Chen ZY, Zheng CH, Su XY,  Intracranial meningioma surgery in the elderly (over 65 years): prognostic factors and outcome. Acta Neurochir (Wien). 2015;157(9):1549\u20131557. doi:10.1007\/s00701-015-2502-9"},{"issue":"5","key":"b19","series-title":"Neurosurgery","first-page":"956","article-title":"Thirty-seven cases of intracranial meningiomas in the ninth decade of life: our experience and review of the literature","volume":"56","author":"D\u2019Andrea G","year":"2005","unstructured":"D\u2019Andrea G, Roperto R, Caroli E, Crispo F, Ferrante L. Thirty-seven cases of intracranial meningiomas in the ninth decade of life: our experience and review of the literature. Neurosurgery. 2005;56(5):956\u2013961."},{"issue":"3","key":"b20","series-title":"Anesth Analg","first-page":"840","article-title":"Two-week multimodal prehabilitation program improves perioperative functional capability in patients undergoing thoracoscopic lobectomy for lung cancer: a randomized controlled trial","volume":"131","author":"Liu Z","year":"2020","unstructured":"Liu Z, Qiu T, Pei L,  Two-week multimodal prehabilitation program improves perioperative functional capability in patients undergoing thoracoscopic lobectomy for lung cancer: a randomized controlled trial. Anesth Analg. 2020;131(3):840\u2013849. doi:10.1213\/ANE.0000000000004342"},{"key":"b21","series-title":"BMC Health Serv Res","first-page":"209","article-title":"Costs and quality of life for prehabilitation and early rehabilitation after surgery of the lumbar spine","volume":"8","author":"Nielsen PR","year":"2008","unstructured":"Nielsen PR, Andreasen J, Asmussen M, T\u00f8nnesen H. Costs and quality of life for prehabilitation and early rehabilitation after surgery of the lumbar spine. BMC Health Serv Res. 2008;8:209. doi:10.1186\/1472-6963-8-209"},{"issue":"11","key":"b22","series-title":"Curr Oncol Rep","first-page":"1513","article-title":"Brain prehabilitation for oncologic surgery","volume":"24","author":"Daksla N","year":"2022","unstructured":"Daksla N, Nguyen V, Jin Z, Bergese SD. Brain prehabilitation for oncologic surgery. Curr Oncol Rep. 2022;24(11):1513\u20131520. doi:10.1007\/s11912-022-01312-1"},{"issue":"11","key":"b23","series-title":"Acta Neurochir (Wien)","first-page":"2987","article-title":"Older meningioma patients: a retrospective population-based study of risk factors for morbidity and mortality after neurosurgery","volume":"164","author":"L\u00f6fgren D","year":"2022","unstructured":"L\u00f6fgren D, Valachis A, Olivecrona M. Older meningioma patients: a retrospective population-based study of risk factors for morbidity and mortality after neurosurgery. Acta Neurochir (Wien). 2022;164(11):2987\u20132997. doi:10.1007\/s00701-022-05336-1"},{"issue":"1","key":"b24","series-title":"J Neurooncol","first-page":"109","article-title":"Symptomatic peritumoral edema is associated with surgical outcome: a consecutive series of 72 supratentorial meningioma patients \u2265 80 years of age","volume":"148","author":"Schwartz C","year":"2020","unstructured":"Schwartz C, Rautalin I, Niemel\u00e4 M, Korja M. Symptomatic peritumoral edema is associated with surgical outcome: a consecutive series of 72 supratentorial meningioma patients \u2265 80 years of age. J Neurooncol. 2020;148(1):109\u2013116. doi:10.1007\/s11060-020-03501-z"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/61\/3\/article-pE11.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/61\/3\/article-pE11.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/61\/3\/article-pE11.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:52Z","timestamp":1788307252000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/61\/3\/article-pE11.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":24,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2026.6.focus26264","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]}}}