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Clinical Manifestations.

Eric Ka J Cheuk1,2, Ellene Yan1,2, Yasmin Alhamdah1

  • 1Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
PubMed
Summary
This summary is machine-generated.

Cognitive impairment (CI) and frailty are common in older surgical patients, with CI patients showing higher frailty prevalence. Early detection of both conditions is key for better surgical recovery and outcomes.

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Area of Science:

  • Geriatric Medicine
  • Anesthesiology
  • Cognitive Neurology

Background:

  • Cognitive impairment (CI) and frailty increase surgical vulnerability.
  • Understanding frailty trajectories in CI patients is crucial for perioperative care.
  • This study investigates frailty prevalence, predictors, and outcomes in older surgical patients with and without CI.

Purpose of the Study:

  • Compare frailty prevalence and trajectory in patients with and without CI post-surgery.
  • Identify patient-centered variables associated with preoperative frailty.
  • Examine clinical outcomes based on baseline frailty levels.

Main Methods:

  • Assessed preoperative cognitive impairment (CI) using AD8, Mini-Cog, and MoCA in patients ≥65 undergoing elective non-cardiac surgery.
  • Measured frailty using the 5-item FRAIL Questionnaire preoperatively and at 30 and 90 days.
  • Utilized logistic regression for variable association and collected clinical outcomes from electronic medical records.

Main Results:

  • Prevalence of CI varied by assessment tool (AD8: 13.6%, Mini-Cog: 12.6%, MoCA: 34.1%).
  • CI patients demonstrated significantly higher frailty across all timepoints (AD8, MoCA).
  • Frailty improved similarly in both CI and non-CI groups; females, orthopedic surgery, functional disability, and OSA risk predicted preoperative frailty.
  • Frail and prefrail patients experienced higher rates of non-home discharge, complications, and adverse outcomes.

Conclusions:

  • Greater frailty prevalence observed in patients with CI, leading to poorer postsurgical outcomes.
  • Early detection of frailty and CI is vital for personalized perioperative management.
  • Tailored strategies can enhance recovery and optimize patient-centered care and clinical outcomes.