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Preoperative Cognitive Assessment in Older Adults

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Principles and Practice of Geriatric Surgery

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Abstract

Cognitive impairment and dementia are common with advancing age. As our population ages a larger number of older adults will undergo surgical procedures requiring anesthesia. While patients with a diagnosis of dementia are less likely to undergo elective surgery and anesthesia, a growing body evidence demonstrates that surgery and anesthesia are more common in older adults when compared to younger adults and children. Interestingly, 20–44% of older patients presenting for elective surgery have undiagnosed probable cognitive impairment that may put them at risk for adverse perioperative outcomes. Accordingly, the detection of probable cognitive impairment is important as it allows for time in the preoperative period for patient and family counseling, identification of surrogate decision-makers, and potential modification to intraoperative and postoperative care to enhance patient centered outcomes. There are several tools available to detect probable cognitive impairment in the preoperative period. This chapter describes the prevalence of preoperative cognitive impairment; its relationship to postoperative outcomes and reviews some of the screening tools that can be used to detect cognitive impairment in older patients.

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Author information

Authors and Affiliations

  1. Department of Medicine, Section of Geriatrics and Palliative Medicine, The University of Chicago Medicine, Chicago, IL, USA

    Lauren Jan Gleason

  2. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital/Harvard Medical School, Boston, MA, USA

    Maria Joao Susano & Deborah J. Culley

  3. Faculty of Medicine, University of Porto, Porto, Portugal

    Maria Joao Susano

  4. Department of Anesthesiology, Emergency and Critical Care, Centro Hospitalar do Porto, Porto, Portugal

    Maria Joao Susano

Authors
  1. Lauren Jan Gleason
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  2. Maria Joao Susano
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  3. Deborah J. Culley
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Corresponding author

Correspondence to Lauren Jan Gleason .

Editor information

Editors and Affiliations

  1. Surgical Service, Yale University School of Medicine VA Connecticut Health Care System, West Haven, Connecticut, USA

    Ronnie A. Rosenthal

  2. SUNY Downstate School of Public Health, National Capital Region Johns Hopkins Medicine, Bethesda, Maryland, USA

    Michael E. Zenilman

  3. Center for Geriatric Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland, USA

    Mark R. Katlic

Section Editor information

  1. Department of Surgery, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA

    Marcia McGory Russell

  2. Ariadne Labs, Boston, MA, USA

    Zara Cooper

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Gleason, L.J., Susano, M.J., Culley, D.J. (2018). Preoperative Cognitive Assessment in Older Adults. In: Rosenthal, R., Zenilman, M., Katlic, M. (eds) Principles and Practice of Geriatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-20317-1_10-1

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  • DOI: https://doi.org/10.1007/978-3-319-20317-1_10-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-20317-1

  • Online ISBN: 978-3-319-20317-1

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