Screening for Mild Cognitive Impairment in the Preoperative Setting: A Narrative Review
Cognitive impairment predisposes patients to the development of delirium and postoperative cognitive dysfunction. In particular, in older patients, the adverse sequelae of cognitive decline in the perioperative period may contribute to adverse outcomes after surgical procedures. Subtle signs of cogn...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/10/6/1112 |
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| author | Mariska te Pas Marcel Olde Rikkert Arthur Bouwman Roy Kessels Marc Buise |
| author_facet | Mariska te Pas Marcel Olde Rikkert Arthur Bouwman Roy Kessels Marc Buise |
| author_sort | Mariska te Pas |
| collection | DOAJ |
| description | Cognitive impairment predisposes patients to the development of delirium and postoperative cognitive dysfunction. In particular, in older patients, the adverse sequelae of cognitive decline in the perioperative period may contribute to adverse outcomes after surgical procedures. Subtle signs of cognitive impairment are often not previously diagnosed. Therefore, the aim of this review is to describe the available cognitive screeners suitable for preoperative screening and their psychometric properties for identifying mild cognitive impairment, as preoperative workup may improve perioperative care for patients at risk for postoperative cognitive dysfunction. Electronic systematic and snowball searches of PubMed, PsycInfo, ClinicalKey, and ScienceDirect were conducted for the period 2015–2020. Major inclusion criteria for articles included those that discussed a screener that included the cognitive domain ‘memory’, that had a duration time of less than 15 min, and that reported sensitivity and specificity to detect mild cognitive impairment. Studies about informant-based screeners were excluded. We provided an overview of the characteristics of the cognitive screener, such as interrater and test-retest reliability correlations, sensitivity and specificity for mild cognitive impairment and cognitive impairment, and duration of the screener and cutoff points. Of the 4775 identified titles, 3222 were excluded from further analysis because they were published prior to 2015. One thousand four hundred and forty-eight titles did not fulfill the inclusion criteria. All abstracts of 52 studies on 45 screeners were examined of which 10 met the inclusion criteria. For these 10 screeners, a further snowball search was performed to obtain related studies, resulting in 20 articles. Screeners included in this review were the Mini-Cog, MoCA, O3DY, AD8, SAGE, SLUMS, TICS(-M), QMCI, MMSE2, and Mini-ACE. The sensitivity and specificity range to detect MCI in an older population is the highest for the MoCA, with a sensitivity range of 81–93% and a specificity range of 74–89%. The MoCA, with the highest combination of sensitivity and specificity, is a feasible and valid routine screening of pre-surgical cognitive function. This warrants further implementation and validation studies in surgical pathways with a large proportion of older patients. |
| first_indexed | 2024-03-09T23:40:33Z |
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| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-09T23:40:33Z |
| publishDate | 2022-06-01 |
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| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-121aeea8a1194b468e63a3fe534455a62023-11-23T16:53:06ZengMDPI AGHealthcare2227-90322022-06-01106111210.3390/healthcare10061112Screening for Mild Cognitive Impairment in the Preoperative Setting: A Narrative ReviewMariska te Pas0Marcel Olde Rikkert1Arthur Bouwman2Roy Kessels3Marc Buise4Department of Anesthesiology, Catharina Hospital, 5623 EJ Eindhoven, The NetherlandsRadboud University Medical Center, Department of Geriatric Medicine, 6500 GL Nijmegen, The NetherlandsDepartment of Anesthesiology, Catharina Hospital, 5623 EJ Eindhoven, The NetherlandsDonders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 XZ Nijmegen, The NetherlandsDepartment of Anesthesiology, Catharina Hospital, 5623 EJ Eindhoven, The NetherlandsCognitive impairment predisposes patients to the development of delirium and postoperative cognitive dysfunction. In particular, in older patients, the adverse sequelae of cognitive decline in the perioperative period may contribute to adverse outcomes after surgical procedures. Subtle signs of cognitive impairment are often not previously diagnosed. Therefore, the aim of this review is to describe the available cognitive screeners suitable for preoperative screening and their psychometric properties for identifying mild cognitive impairment, as preoperative workup may improve perioperative care for patients at risk for postoperative cognitive dysfunction. Electronic systematic and snowball searches of PubMed, PsycInfo, ClinicalKey, and ScienceDirect were conducted for the period 2015–2020. Major inclusion criteria for articles included those that discussed a screener that included the cognitive domain ‘memory’, that had a duration time of less than 15 min, and that reported sensitivity and specificity to detect mild cognitive impairment. Studies about informant-based screeners were excluded. We provided an overview of the characteristics of the cognitive screener, such as interrater and test-retest reliability correlations, sensitivity and specificity for mild cognitive impairment and cognitive impairment, and duration of the screener and cutoff points. Of the 4775 identified titles, 3222 were excluded from further analysis because they were published prior to 2015. One thousand four hundred and forty-eight titles did not fulfill the inclusion criteria. All abstracts of 52 studies on 45 screeners were examined of which 10 met the inclusion criteria. For these 10 screeners, a further snowball search was performed to obtain related studies, resulting in 20 articles. Screeners included in this review were the Mini-Cog, MoCA, O3DY, AD8, SAGE, SLUMS, TICS(-M), QMCI, MMSE2, and Mini-ACE. The sensitivity and specificity range to detect MCI in an older population is the highest for the MoCA, with a sensitivity range of 81–93% and a specificity range of 74–89%. The MoCA, with the highest combination of sensitivity and specificity, is a feasible and valid routine screening of pre-surgical cognitive function. This warrants further implementation and validation studies in surgical pathways with a large proportion of older patients.https://www.mdpi.com/2227-9032/10/6/1112mild cognitive impairmentpreoperativecognitive screeningsensitivity and specificitypostoperative cognitive dysfunction (POCD)postoperative delirium (POD) |
| spellingShingle | Mariska te Pas Marcel Olde Rikkert Arthur Bouwman Roy Kessels Marc Buise Screening for Mild Cognitive Impairment in the Preoperative Setting: A Narrative Review Healthcare mild cognitive impairment preoperative cognitive screening sensitivity and specificity postoperative cognitive dysfunction (POCD) postoperative delirium (POD) |
| title | Screening for Mild Cognitive Impairment in the Preoperative Setting: A Narrative Review |
| title_full | Screening for Mild Cognitive Impairment in the Preoperative Setting: A Narrative Review |
| title_fullStr | Screening for Mild Cognitive Impairment in the Preoperative Setting: A Narrative Review |
| title_full_unstemmed | Screening for Mild Cognitive Impairment in the Preoperative Setting: A Narrative Review |
| title_short | Screening for Mild Cognitive Impairment in the Preoperative Setting: A Narrative Review |
| title_sort | screening for mild cognitive impairment in the preoperative setting a narrative review |
| topic | mild cognitive impairment preoperative cognitive screening sensitivity and specificity postoperative cognitive dysfunction (POCD) postoperative delirium (POD) |
| url | https://www.mdpi.com/2227-9032/10/6/1112 |
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