4 months ago
Evaluation of a Digital, Self-Administered, Cognitive Test Battery in Older Adult Patients Undergoing Abdominal Surgery: Nonrandomized #feasibility Trial
Background: Older adults undergoing surgery face increased risks of postoperative neurocognitive disorders which impair cognitive functions. Analog neurocognitive tests are commonly used, but digital tests offer faster, more accessible assessments. Objective: The primary aim was to evaluate the #feasibility of a digital cognitive test battery in older adults undergoing abdominal surgery. #feasibility included estimation of recruitment and retention rates, acceptability, perceived value and #usability of the test. The secondary aim was to explore outcome trajectories of cognition, depression, functional status and quality of recovery. Methods: A non-randomized #feasibility study. Recruitment and retention rates were measured using patient logs and expanded upon in semi-structured interviews with nurses. Acceptability, perceived value, and #usability were explored through interviews with patients and nurses, and the System #usability Scale (SUS). Cognitive functions were assessed with a digital cognitive test battery (CERAD, TMT A+B, Stroop, SDPT) and the Nursing Delirium Screening scale, and depression with the Geriatric Depression Scale. Functional status was measured using World Health Organization Disability Assessment Schedule, and postoperative recovery with the Swedish Quality of Recovery questionnaire. Quantitative data were analyzed using descriptive statistics and non-parametric tests and qualitative data with content analysis. Results: The test battery was feasible, acceptable and demonstrated excellent #usability. The mean SUS score was 87 (SD=17.9, 95% CI: 78.9-95.2), and all predefined progression criteria were met. Recruitment spanned over 1.5 years, during which 24 patients were included (mean age of 77 years, range 63-90, 56% women). Most patients underwent laparoscopic colorectal #Cancer surgery. Three patients developed postoperative delirium for one day only. No patient developed delayed neurocognitive recovery or mild/major neurocognitive disorder at the postoperative follow-up. Qualitative data showed that both nurses and patients regarded the digital cognitive test battery as important for assessing cognitive function, and found it easy to use and understand. Nurses reported that recruitment was challenging, partly because not all patients attended a preoperative in-person consultation prior to surgery. Conclusions: The digital, self-administered cognitive test battery was found to be feasible, acceptable, and usable in older adults undergoing abdominal surgery. However, recruitment challenges and a small, homogeneous sample limit generalizability and warrant careful consideration in a larger-scale study. Clinical Trial: NCT05564195, registration date 2022-10-03.
JMIR Formative Res: Evaluation of a Digital, Self-Administered, Cognitive Test Battery in Older Adult Patients Undergoing Abdominal Surgery: Nonrandomized #feasibility Trial #CognitiveTesting #DigitalHealth #OlderAdults #PostoperativeCare #NeurocognitiveDisorder
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