ArticleAnesthesia and analgesia2019
Feasibility and Rationale for Incorporating Frailty and Cognitive Screening Protocols in a Preoperative Anesthesia Clinic.
Article in Anesthesia and analgesia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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Who cites it
34 citing papers in PubMed, 72 citations in OpenAlex.
- Perioperative Artificial Intelligence Driven Integrated Modeling of Surgeries using Anesthetic, Physical and Cognitive Statuses for Predicting Hospital Outcomes.Research square · 2025Article
- External validation of an AI-based preoperative frailty index using real-world data.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- Older adult patient satisfaction with brain health exams prior to surgery.Perioperative care and operating room management · 2025Article
- Article
- Association Between Preoperative Anemia and Cognitive Function in a Large Cohort Study of Older Patients Undergoing Elective Surgery.Anesthesia and analgesia · 2025Article
- Enhancing Frailty Assessments for Transcatheter Aortic Valve Replacement Patients Using Structured and Unstructured Data: Real-World Evidence Study.JMIR aging · 2024Article
- Low blood S-methyl-5-thioadenosine is associated with postoperative delayed neurocognitive recovery.Communications biology · 2024Article
- Developing a fair and interpretable representation of the clock drawing test for mitigating low education and racial bias.Scientific reports · 2024Article
- Prevalence and characteristics of preoperative patients with depression.British journal of anaesthesia · 2024Article
- Article
- FaIRClocks: Fair and Interpretable Representation of the Clock Drawing Test for mitigating classifier bias against lower educational groups.Research square · 2023Article
- Feasibility of frailty screening among patients with advanced heart failure.BMJ open quality · 2023Article
- Article
- A Geriatric Approach to Percutaneous Coronary Interventions in Older Adults, Part II: AJACC. Advances · 2023Article
- Explainable semi-supervised deep learning shows that dementia is associated with small, avocado-shaped clocks with irregularly placed hands.Scientific reports · 2023Article
- Perioperative Extracellular Brain Free-Water Changes for Older Adults Electing Total Knee Arthroplasty with General versus Spinal Anesthesia: A Pilot Study.Journal of Alzheimer's disease : JAD · 2023Article
- Preoperative cognition predicts clinical stroke/TIA and mortality after surgical aortic valve replacement in older adults.Journal of clinical and experimental neuropsychology · 2022Article
- Variational autoencoder provides proof of concept that compressing CDT to extremely low-dimensional space retains its ability of distinguishing dementia.Scientific reports · 2022Article
- The functional connectivity and neuropsychology underlying mental planning operations: data from the digital clock drawing test.Frontiers in aging neuroscience · 2022Article
- The New Frontier of Perioperative Cognitive Medicine for Alzheimer's Disease and Related Dementias.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2022Review
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundAdvanced age, frailty, low education level, and impaired cognition are generally reported to be associated with postoperative cognitive complications. To translate research findings into hospital-wide preoperative assessment clinical practice, we examined the feasibility of implementing a preoperative frailty and cognitive assessment for all older adults electing surgical procedures in a tertiary medical center. We examined associations among age, education, frailty, and comorbidity with the clock and 3-word memory scores, estimated the prevalence of mild to major cognitive impairment in the presurgical sample, and examined factors related to hospital length of stay.
methodsMedical staff screened adults ≥65 years of age for frailty, general cognition (via the clock-drawing test command and copy, 3-word memory test), and obtained years of education. Feasibility was studied in 2 phases: (1) a pilot phase involving 4 advanced nurse practitioners and (2) a 2-month implementation phase involving all preoperative staff. We tracked sources of missing data, investigated associations of study variables with measures of cognition, and used 2 approaches to estimate the likelihood of dementia in our sample (ie, using extant data and logistic regression modeling and using Mini-Cog cut scores). We explored which protocol variables related to hospital length of stay.
resultsThe final implementation phase sample included 678 patients. Clock and 3-word memory scores were significantly associated with age, frailty, and education. Education, clock scores, and 3-word scores were not significantly different by surgery type. Likelihood of preoperative cognitive impairment was approximately 20%, with no difference by surgery type. Length of stay was significantly associated with preoperative comorbidity and performance on the clock copy condition.
conclusionsFrailty and cognitive screening protocols are feasible and provide information for perioperative care planning. Challenges to clinical adaptation include staff training, missing data, and additional administration time. These challenges appear minimal relative to the benefits of identifying frailty and cognitive impairment in a group at risk for negative postoperative cognitive outcome.
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