Assessment of Postoperative Cognitive Decline

Neurocognitive outcome studies are a potentially rich source of information for evidence-based approaches to neuroprotection. This chapter provides a critical examination of assessment methods for studying postoperative cognitive decline (POCD), with regard to definition of the phenomenon, the role of hypotheses regarding mechanisms and localization of neural injury, and psychometric considerations for the design of POCD assessment protocols. It also describes an approach to conducting clinical neuropsychological assessments outside of research contexts for patients who present with signs or...

Neurocognitive outcome studies are a potentially rich source of information for evidence-based approaches to neuroprotection. This chapter provides a critical examination of assessment methods for studying postoperative cognitive decline (POCD), with regard to definition of the phenomenon, the role of hypotheses regarding mechanisms and localization of neural injury, and psychometric considerations for the design of POCD assessment protocols. It also describes an approach to conducting clinical neuropsychological assessments outside of research contexts for patients who present with signs or symptoms of POCD when there are no preoperative baseline cognitive test data. The authors propose a set of guidelines for designing, conducting, interpreting, and evaluating cognitive outcome studies in surgical patients and performing clinical POCD assessments.