Prognostic Factors Associated With Postoperative Cognitive Dysfunction After Surgery

Study Overview
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Brief Summary
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A longitudinal observational study examining preoperative, intraoperative and postoperative factors associated with Postoperative Cognitive Dysfunction in patients older than the age of 50.

Detailed Description
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A longitudinal observational study examining factors associated with Postoperative Cognitive Dysfunction (POCD) utilizing a computerized neurocognitive battery. In addition, investigators seek to assess the presence of pre-existing psychiatric disorders and chronic pain to determine their relationship with POCD. The study will seek to compare the rates of POCD in previously published literature with performance on a computerized neurocognitive battery. In addition, the study will seek to determine preoperative, intraoperative and postoperative factors associated with POCD by comparing these variables to performance on a computerized neurocognitive battery.

Official Title
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Delineating Neurocognitive Prognostic Factors Associated With Postoperative Cognitive Dysfunction After General or Neuraxial Anesthesia Utilizing the CogState Brief Battery

Conditions
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Postoperative Cognitive Dysfunction

Intervention / Treatment
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* Other: Neurocognitive Testing


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Ability to perform informed consent Age greater than 50 years old Ability to read and understand English Undergoing elective surgery with general or neuraxial anesthesia Exclusion Criteria: Patients who do not meet above defined criteria, patients from vulnerable populations (adults unable to consent, pregnant women, prisoners), patients refusing informed consent and participation in the study. A previous history of the following medical conditions: dementia of any kind (vascular dementia, Alzheimer's disease, organic brain disease with documented cognitive deficits, severe traumatic brain injury, Parkinson's disease, senility) Physical impairment impairing their ability to perform neurocognitive testing incl. essential tremor, loss of upper extremity motor function, blindness, or severe hearing loss)

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Neurocognitive Testing|neurocognitive testing, computerized|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in performance on the CogState Brief Battery | Neurocognitive Test. Detection Task (Score: normal - abnormal), One Card Learning Task (Score: normal - abnormal) One Back Task (Score normal - abnormal) Identification Task (Score normal - Abnormal) Scores are based on normal distributed population data. Scores are measured on a linear scale with no maximum score. Research subjects will also act as their own control based on baseline performance in this longitudinal study. | Change from baseline on the Cogstate Brief Battery score at postoperative Day 30-40. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in performance on the Beck Clinical Depression Inventory (BDI) | Test for symptoms of clinical depression. (Scored: 1 to >40 from normal to extreme depression) | Change in baseline on the Beck Clinical Depression Inventory at postoperative Day 30-40. | 
| Change in performance on the Short-Form McGill Pain Questionnaire (SF-MPQ-2) | Test of presence of chronic pain (Scored 0-3(severe)) Validates the sensory component of neuropathic or chronic pain, a visual analog scale (Scored: no pain to worst possible pain) and a Present Pain Intensity (Scored: 0-5 (worst)). | Change in baseline on the SF-MPQ-2 at postoperative Day 30-40. | 
| Barthel Index of Activities of Daily Living | Scale to assess independent function of patient. Components assessing continence, mobility, transfer skills, grooming, hygiene, feeding, bathing, stairs and dressing. (Scored: 0-2, dependent - completely independent) Total Score 0-20 (fully dependent - fully independent) | Change in baseline on the Barthel Index at postoperative Day 30-40. |