Greek Validation of ACE III Test in Perioperative Patients

Study Overview
=================
Brief Summary
-----------------
Postoperative neurocognitive disorders, including postoperative delirium (POD) and postoperaive cognitive dysfunction (POCD), are common complications of perioperative neurocognition in elderly patients undergoing surgery. POD and POCD have short- and long-term consequences, such as increased hospital stays and costs, augmented morbidity and mortality, as well as higher risk for cognitive decline later in life. Therefore, early prevention and diagnosis of these conditions is of great importance. A number of psychometric tests have been proposed as cognitive screening tools. Given the fact that many of them show weaknesses and difficulties in performance, scientists have sought for more useful alternatives. Montreal Cognitive Assessment (MoCA) is considered to be a good choice, as it has been successfully applied in the perioperative setting. What's more, it has been translated and validated for a Greek population with neurological disorders. Addenbrooke's Congnitive Examination III (ACE III) has been introduced recently into clinical practice. It is an easy to perform and detailed test that covers several neurocognitive domains and has shown high sensitivity and specificity in clinical conditions, including dementia and Alzheimer's disease. Although current literature lacks data concerning its perioperative use, ACE III could prove useful for screening patients undergoing surgery and anesthesia on the basis of its favorable characteristics as mentioned above. The aim of this study is to translate the ACE III (English version 2012) into Greek and assess its validity in perioperative patients aged >55 years.

Detailed Description
-----------------
In this prospective cohort study, the ACE III will be translated and adapted into Greek by the researchers according to the relative guidelines for cultural adaptation. Backwards translation will be performed by a fluent bilingual specialist in order to ensure optimum reliability of the questionnaire. Following power-analysis, 110 surgical patients and 70 healthy volunteers will be included in the study protocol after informed consent.. Primary screening of the whole population will be conducted using the MoCA test by two examiners. Simultaneously, the ACE III will be applied in order to set baseline measurements for each participant. Healthy volunteers and patients with MoCA scores at least 26 will form the control group. Retesting of patients and controls with both questionnaires will be held 48 hours after initial assessment by the same examiners. One third of the population will be assessed at the above time-points by an observer to minimize subjectivity of examination. Total scores and subscores at both time-points will be calculated and comparative performance of all participants will be assessed after statistical analysis of collected data.

Official Title
-----------------
Validation of the Greek Version of Addenbrooke's Cognitive Examination III (English Version 2012) in Perioperative Patients

Conditions
-----------------
Postoperative Delirium, Postoperative Cognitive Dysfunction

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: At least primary level of education Exclusion Criteria: Healthy volunteers with MoCA scores <26 Neurodegenerative disease Cerebrovascular disease Psychiatric disorders History of head injury Use of medication affecting the CNS

Ages Eligible for Study
-----------------
Minimum Age: 55 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Controls<br>Healthy volunteers without neurocognitive impairment | |
| Patients<br>Patients undergoing surgical procedure with at least mild cognitive impairment preoperatively | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Validation | Validation of ACE III (English version 2012) into Greek | 2 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
ACE III, MoCA, Neurocognitive dysfunction, Perioperative