#Moca test scoring of 17 trial
#Moca test scoring of 17 professional

Knowing the importance of preoperative cognitive assessment led us to trial the MoCA 5-minute test/Telephone (which we will refer to as the T-MoCA) in older adults who are candidates for major surgery. However, with the start of the COVID-19 pandemic in early 2020, our pre-op clinics performed virtual visits instead of in-person assessments, making the Mini-Cog no longer possible. Prior to the COVID-19 pandemic, we routinely performed preoperative cognitive testing with the Mini-Cog during the in-person visits to our preoperative assessment clinic (Sherman et al. There are multiple cognitive assessments available, including the Mini-Cog, Mini-Mental State Exam (MMSE), and Montreal Cognitive Assessment (MoCA) (Arias et al.

#Moca test scoring of 17 professional

The potentially detrimental consequences of postoperative cognitive impairment in this population have led to calls for action by multiple professional groups, including the American Society of Anesthesiologists (ASA) with their Perioperative Brain Health Initiative, as well as the American Geriatric Society and American College of Surgeons (Decker et al. However, preoperative cognitive assessments are performed in less than 10% of the older adults presenting to surgery (Mahanna-Gabrielli et al. These complications can negatively impact the benefits associated with the surgery (Arias et al. Undiagnosed preoperative cognitive impairment is associated with increased postoperative complications including postoperative delirium, postoperative cognitive dysfunction, non-home discharge, increased length of stay, and increased risk of mortality (Decker et al. Further research is needed to better define validity and correlation with postoperative outcomes.

This test is feasible for virtual assessments. Preoperative cognitive assessment of older adults using T-MoCA over the phone is easy to perform by clinicians and had a high completion rate by patients. Clinician’s survey reported ease and feasibility in performing T-MoCA as a preoperative cognitive evaluation. Most patients (37/40) completed the post-operative assessment, and 6/37 (16.2%) reported they had experienced a change in memory or attention post-operatively. Median completion time of the phone assessment was 10 min (IQR 8.25-12) and 4 min (IQR 3-5) for the T-MoCA with a median T-MoCA score of 13 (IQR 12-14). Preoperatively, the median number of medications was 8 (IQR 7-11), 27/40 (67.5%) had medications with anticholinergic effects, and 6/40 (15%) had benzodiazepines. The cohort was 50% female, white (97.5%), with a median age of 76 years (interquartile range (IQR) 73-79), and education level was higher than high school in 82.5% of patients. Overall, 37/40 (92.5%) patients completed the pre- and post-operative assessments. MeasurementsĪn attention test, T-MoCA, Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), and Generalized Anxiety Disorder 2-item (GAD-2) Main results Follow-up assessment was completed 1-month postoperatively, and participating clinicians were surveyed at the completion of the study. Patients ≥70 years undergoing major elective surgery InterventionĪ study investigator called eligible patients prior to surgery, obtained consent, and completed the preoperative cognitive assessment. To assess the feasibility of administering the MoCA 5-minute test/Telephone (T-MoCA), an abbreviated version of the Montreal Cognitive Assessment to older adults perioperatively DesignĪ feasibility study including patients aged ≥ 70 years scheduled for surgery from December 2020 to March 2021 Setting