Degree Name
Nurse Anesthesia, DNP
Publication Date
2017
Upload Date
2024
First Advisor
Lorena Thompson
Second Advisor
Erick Schuermann
Abstract
The purpose of this prospective, descriptive pilot study is to establish a baseline measure for mild cognitive impairment (MCI) in patients aged 65-80 years following elective surgery with general anesthesia (GA). Older adults scheduled for elective surgery routinely undergo GA with a combination of volatile and intravenous anesthetic agents. Current literature shows that patients aged 65-80 who receive GA agents are at increased risk for MCI postoperatively. Data also suggests that further studies are necessary in order to more completely evaluate alternative anesthesia techniques and agents that may prove to reduce the risk and incidence of MCI associated with anesthesia following surgery. In order to establish a baseline measure of incidence of MCI, a reliable and effective assessment tool must implemented into routine anesthesia practice. This study is designed to put into operation the use of the Montreal Cognitive Assessment-Blind (MoCA-Blind) [Appendix I] as the measurement tool for MCI in the older population of surgical patients undergoing GA. The MoCA-Blind exam will be administered to the first eligible patients that meet inclusionary criteria for this study during the preoperative interview phase prior to anesthesia administration and twice more on days 7 and 14 following the day of surgery to assess for MCI. Patient selection will be contingent on meeting all inclusionary criteria, willingness to participate in the study, comprehension of informed consent and HIPAA authorization. Sensory impairments are extremely prevalent in older patient populations. Substantial hearing loss is noted in approximately 1 out of every 3 geriatric patients, while uncorrectable vision problems occur in approximately 1 of 10. Taking into account the prevalence of age-related vision loss, the MoCA test has been modified by extracting all four visual items from the exam to create a new scoring procedure known as the MoCA-Blind. While these modifications reduce the overall sensitivity of the test from 90% to 44% for patients with MCI and from 100% to 87% for patients with AD, the MoCA-Blind results in test specificity of 98% (Dupuis et al. 2015).
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Ward, Bryon, "Investigating The Incidence Of Postoperative Mild Cognitive Impairment In Cognitively Intact Patients Aged 65-80 Years Undergoing General Anesthesia For Surgery" (2017). Doctor of Nursing Practice Projects. 13.
https://arch.astate.edu/dnp-projects/13
