A Remote Comprehensive Neurocognitive Test Battery to Monitor Postoperative Neurocognitive Dysfunction in Older...

Area of Science:

• Geriatric Medicine
• Neuroscience
• Surgical Outcomes

Background:

• Postoperative cognitive dysfunction (POCD) risks are poorly understood, with traditional screening tools lacking scope.
• Comprehensive in-person cognitive testing presents challenges for long-term follow-up in perioperative care.

Purpose of the Study:

• To assess the feasibility of a remotely administered comprehensive neurocognitive test battery (UDS v3.0 T-cog) for evaluating long-term neurocognitive outcomes.
• To evaluate patient satisfaction with the remote assessment in older adults undergoing orthopedic joint arthroplasty.

Main Methods:

• Prospective cohort study involving remote UDS v3.0 T-cog administration at baseline, 1 week, 1 month, and 3 months postoperatively.
• Patient-reported outcome measures (PROMs) including the Uniform Data Set tele-adapted neuropsychological battery version 3 (UDS v3.0 T-cog), PROMIS scales, McGill Pain Questionnaire, and Pain Catastrophizing Scale were used.
• Participant satisfaction with the remote assessment was evaluated via surveys at 3 months post-surgery.

Main Results:

• 127 participants enrolled; 98 completed 3-month cognitive assessments.
• 17% of participants exhibited objective cognitive decline at 3 months post-surgery.
• The remote UDS v3.0 T-cog demonstrated high participant satisfaction and retention, identifying specific cognitive deficits missed by brief screening tools.

Conclusions:

• This study is the first to use a comprehensive remote cognitive assessment tool for long-term postoperative cognitive function.
• Remote comprehensive cognitive assessments are effective for early detection and risk stratification of perioperative neurocognitive dysfunction in older surgical patients.
• The UDS v3.0 T-cog can be integrated with preoperative outcome assessments for enhanced perioperative care in older adults.