Optimizing Postoperative Cognition the Elderly

Mount Sinai Health System

Status: Completed

Conditions: POCD; Postoperative Cognitive Dysfunction

Treatments: Procedure: Processed EEG

Study type: Observational

Funder types: Other; NIH

Identifiers

NCT02650687

1K23AG048332-01A1 (U.S. NIH Grant/Contract)

GCO 13-1692

Details and patient eligibility

About

This study will recruit surgical patients more than 65 years old. Patients who participate will wear a sticker on their forehead during surgery which monitors their brain waves (electroencephalogram, EEG) and participate in memory testing before and after surgery. Brain wave patterns will be compared between patients who have problems with memory and thinking after surgery and those who do not. The hypothesis is that there will be characteristic brain wave patients for who will go on to have problems with memory and thinking after surgery.

Full description

Eligible patients will be identified through the computerized scheduling system at the Icahn School of Medicine at Mount Sinai. After informed consent, patients will complete cognitive and tests at least one but not more than 30 days prior to surgery. In the recovery room the Post Anesthesia Recovery Scale (PQRS), and CAM-ICU delirium screening will be administered. Immediate recovery will be recorded using the Postoperative Recovery Scale (PQRS) on postoperative day 1 and 3, and 1 week.

Longterm functional recovery will be measured with the Alzheimer's Disease Research Center (ADRC) Instrumental Activities for Daily Living (IADL-24). Postsurgical complications will be recorded including unplanned ICU admissions, postoperative myocardial infarction and stroke (risk less than 1 % in most cases), wound infection and reoperation. The full cognitive and functional battery will be repeated at 3 months and 1 year after surgery.

Enrollment: 178 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 65 years of age and older
• having major elective non-cardiac surgery requiring general anesthesia requiring at least a 2 day hospital stay

Exclusion criteria

• previous diagnosis of dementia, stroke, cardiac or intracranial surgery
• inability to consent or communicate in English or Spanish
• major uncorrected hearing or vision deficit, Parkinson's disease, or major psychiatric disease which will be determined by phone interview and computer medical records abstracted by the primary investigator.

Trial design

178 participants in 1 patient group

Elective Non Cardiac Surgical Patients

Description:

65 years of age and older

Treatment:

Procedure: Processed EEG