Feasibility of administrating a cognitive screening tool by telephone prior to surgery in older adults-preliminary results

Background: Preoperative cognitive assessment has been advocated for adults ≥ 65 years-old due to increased risk for post-operative complications such as postoperative delirium, postoperative cognitive decline, and increased mortality Most screening tools for cognitive impairment require in-person evaluation During the COVID-19 pandemic, most medical centers have changed their workflows to telemedicine platforms In this study we aim to assess the feasibility of a telephone-based cognitive assessment tool, the Mini-Montreal Cognitive Assessment (Mini-MOCA) prior to surgery and 30-day post surgery to evaluate any changes in cognitive function Methods: Patients age ≥70 year who were candidates for surgery and had a telemedicine visit in the preoperative clinic during December 2020 were included Exclusion criteria included hearing impairment, day-surgery, inability to speak English and a prior diagnosis of Dementia Eligible patients were asked to complete an attention test, the Mini-MOCA and function assessment using the Katz score for activities of daily living (ADL) and Lawton-Brody for instrumental activities of daily living (IADL) Anxiety was assessed using the Generalized Anxiety Disorder 2-item (GAD-2) Baseline demographics including medications and education level were collected Anti-cholinergic effect was assessed using an anti-cholinergic score calculator (ACS) Results: Overall 24 patients completed the preoperative assessment The cohort was 50% female, white (96%), with a median age of 74 years (range: 71-82) The median number of medications was 8 (range:2-20), 16/24 (67%) taking medications with anti-cholinergic effects and a median ACS of 1 (range 1-13), and 4/24 (17%) on Benzodiazepines The median Katz score was 6 (range: 4-6) and Lawton-Brody score 8 (range: 5-8) The mean time for completion of the phone assessment was 10 minutes and 4 minutes for the Mini- MOCA The median Mini-MOCA score was 13 5 (range: 9-15) Conclusions: In our preliminary results we show that a telephone- based cognitive assessment prior to surgery is well accepted and feasible among older adults who are candidates for surgery Our study is ongoing, and will continue to conduct pre- and post-operative cognitive evaluations (updated results will be presented)