Preoperative Cognitive Assessment in Older Adults

  • Lauren Jan Gleason
  • Maria Joao Susano
  • Deborah J. Culley
Living reference work entry


Cognitive impairment and dementia are common with advancing age. As our population ages a larger number of older adults will undergo surgical procedures requiring anesthesia. While patients with a diagnosis of dementia are less likely to undergo elective surgery and anesthesia, a growing body evidence demonstrates that surgery and anesthesia are more common in older adults when compared to younger adults and children. Interestingly, 20–44% of older patients presenting for elective surgery have undiagnosed probable cognitive impairment that may put them at risk for adverse perioperative outcomes. Accordingly, the detection of probable cognitive impairment is important as it allows for time in the preoperative period for patient and family counseling, identification of surrogate decision-makers, and potential modification to intraoperative and postoperative care to enhance patient centered outcomes. There are several tools available to detect probable cognitive impairment in the preoperative period. This chapter describes the prevalence of preoperative cognitive impairment; its relationship to postoperative outcomes and reviews some of the screening tools that can be used to detect cognitive impairment in older patients.


Cognitive impairment Dementia Delirium Informed consent Shared-decision making Surgery Preoperative evaluation 


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Copyright information

© Springer International Publishing Switzerland 2018

Authors and Affiliations

  • Lauren Jan Gleason
    • 1
  • Maria Joao Susano
    • 2
    • 3
    • 4
  • Deborah J. Culley
    • 2
  1. 1.Department of Medicine, Section of Geriatrics and Palliative MedicineThe University of Chicago MedicineChicagoUSA
  2. 2.Department of Anesthesiology, Perioperative and Pain MedicineBrigham and Women’s Hospital/Harvard Medical SchoolBostonUSA
  3. 3.Faculty of MedicineUniversity of PortoPortoPortugal
  4. 4.Department of Anesthesiology, Emergency and Critical CareCentro Hospitalar do PortoPortoPortugal

Section editors and affiliations

  • Marcia McGory Russell
    • 1
  • Zara Cooper
    • 2
  1. 1.Department of SurgeryDavid Geffen School of Medicine at the University of CaliforniaLos AngelesUSA
  2. 2.Ariadne LabsBostonUSA

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