INS NYC 2024 Program

Poster	Poster Session 08 Program Schedule 02/16/2024 01:45 pm - 03:00 pm Room: Shubert Complex (Posters 1-60) Poster Session 08: Cognition \| Cognitive Reserve Variables Final Abstract #34 Frailty Severity on Preoperative Cognitive Abilities in Attention and Memory Yonah Joffe, University of Florida, Gainesville, United States Shawna Amini, University of Florida, Gainesville, United States Faith Kimmet, University of Florida, Gainesville, United States David Libon, Rowan University, Stratford, United States Cynthia Garvan, University of Florida, Gainesville, United States Catherine Price, University of Florida, Gainesville, United States Category: Aging Keyword 1: aging (normal) Keyword 2: cognitive functioning Objective: More than half a million older adults aged 65 and older are referred for low and high-risk operations a year (Williams et al., 2015). Yet, hospitals do not routinely consider the relationship between preoperative cognitive impairment and frailty as factors relative to perioperative outcomes. This investigation assessed frailty index scores relative to those with preoperative cognitive deficits in attention, memory, both, or none among older adults referred to the Perioperative Cognitive Anesthesia Network (PeCAN^SM) within a tertiary hospital. Although research has shown increased frailty in older adults with dysexecutive profiles among memory clinic patients (Ginsberg et al., 2017), these relationships have not been examined among older adults entering a complex perioperative setting in preparation for surgery. Participants and Methods: Participant data were obtained with Health Insurance Portability and Accountability Act (HIPAA) waiver and honest broker medical extraction from January 2018 to December 2019. The PeCAN^SM program has two preoperative phases: Phase 1) nurses administer the digital 3-word memory and digital Clock Drawing tests and assess or frailty (Amini et al., 2019); Phase 2) Patients who failed cognitive screening are referred for further neuropsychological assessment to assist with preoperative planning. Primary outcome metrics: Fried Frailty Score (Fried et al., 2001), standardized memory composite: Hopkins Verbal Learning Test-Revised immediate, delay-free recall, and delay recognition; standardized attention/working memory composite: letter ‘F’ fluency, WAIS-III Digit Span Forwards span, Backwards span. The Kruskal-Wallis test was used to compare the degree of frailty relative to cognitive phenotype (attention, memory, both attention and memory, no deficits). Results: The UF Health preoperative anesthesia nurses assessed 12,880 patients in Phase 1. Of these, 2,991 were referred for further assessment. This disproportionally affected those who were older, Black, widowed, and/or had lower education. There were 1,363 patients who completed Phase 2 neuropsychological assessment; 960 were classified as having at least mild deficits in attention (n=162), memory (n=371), or both (n=427). Frailty differed by cognitive phenotype (p< .0001). Fried criteria frailty scores of ≥3 were more frequent in those with attention/dysexecutive (30.57%), and combined attention/dysexecutive and memory deficits (29.35%), compared to those with memory deficits (23.33%) versus no deficits (19.83%). Conclusions: Consistent with prior research, frailty was higher among individuals with attention deficits. This is the first study to show this pattern in the preoperative arena. Appreciating patients’ pattern of preoperative frailty with neurocognitive phenotype may improve prediction for intraoperative response and postoperative cognitive complications. Future research needs to examine the neuroanatomical pathways linking frailty pre- and postoperative neurocognitive phenotypes. Funding: R01AG055337; K07AG066813.

Poster

02/16/2024
01:45 pm - 03:00 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 08: Cognition | Cognitive Reserve Variables

Final Abstract #34

Frailty Severity on Preoperative Cognitive Abilities in Attention and Memory

Yonah Joffe, University of Florida, Gainesville, United States
Shawna Amini, University of Florida, Gainesville, United States
Faith Kimmet, University of Florida, Gainesville, United States
David Libon, Rowan University, Stratford, United States
Cynthia Garvan, University of Florida, Gainesville, United States
Catherine Price, University of Florida, Gainesville, United States

Category: Aging

Keyword 1: aging (normal)
Keyword 2: cognitive functioning

Objective:

More than half a million older adults aged 65 and older are referred for low and high-risk operations a year (Williams et al., 2015). Yet, hospitals do not routinely consider the relationship between preoperative cognitive impairment and frailty as factors relative to perioperative outcomes. This investigation assessed frailty index scores relative to those with preoperative cognitive deficits in attention, memory, both, or none among older adults referred to the Perioperative Cognitive Anesthesia Network (PeCAN^SM) within a tertiary hospital. Although research has shown increased frailty in older adults with dysexecutive profiles among memory clinic patients (Ginsberg et al., 2017), these relationships have not been examined among older adults entering a complex perioperative setting in preparation for surgery.

Participants and Methods:

Participant data were obtained with Health Insurance Portability and Accountability Act (HIPAA) waiver and honest broker medical extraction from January 2018 to December 2019. The PeCAN^SM program has two preoperative phases: Phase 1) nurses administer the digital 3-word memory and digital Clock Drawing tests and assess or frailty (Amini et al., 2019); Phase 2) Patients who failed cognitive screening are referred for further neuropsychological assessment to assist with preoperative planning. Primary outcome metrics: Fried Frailty Score (Fried et al., 2001), standardized memory composite: Hopkins Verbal Learning Test-Revised immediate, delay-free recall, and delay recognition; standardized attention/working memory composite: letter ‘F’ fluency, WAIS-III Digit Span Forwards span, Backwards span. The Kruskal-Wallis test was used to compare the degree of frailty relative to cognitive phenotype (attention, memory, both attention and memory, no deficits).

Results:

The UF Health preoperative anesthesia nurses assessed 12,880 patients in Phase 1. Of these, 2,991 were referred for further assessment. This disproportionally affected those who were older, Black, widowed, and/or had lower education. There were 1,363 patients who completed Phase 2 neuropsychological assessment; 960 were classified as having at least mild deficits in attention (n=162), memory (n=371), or both (n=427). Frailty differed by cognitive phenotype (p< .0001). Fried criteria frailty scores of ≥3 were more frequent in those with attention/dysexecutive (30.57%), and combined attention/dysexecutive and memory deficits (29.35%), compared to those with memory deficits (23.33%) versus no deficits (19.83%).

Conclusions:

Consistent with prior research, frailty was higher among individuals with attention deficits. This is the first study to show this pattern in the preoperative arena. Appreciating patients’ pattern of preoperative frailty with neurocognitive phenotype may improve prediction for intraoperative response and postoperative cognitive complications. Future research needs to examine the neuroanatomical pathways linking frailty pre- and postoperative neurocognitive phenotypes. Funding: R01AG055337; K07AG066813.