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Implementation of Routine Cognitive Screening in the Preoperative Assessment Clinic

Sherman, Julia B., BA*,†; Chatterjee, Abhirup, BSc; Urman, Richard D., MD, MBA; Culley, Deborah J., MD; Crosby, Gregory J., MD; Cooper, Zara, MD; Javedan, Houman, MD§; Hepner, David L., MD, MPH; Bader, Angela M., MD, MPH

doi: 10.1213/XAA.0000000000000891

Traditional systems of anesthesia evaluation do not routinely incorporate cognitive screening into preoperative assessments of vital organ systems. Increasing recognition of the importance of preoperative cognitive assessment of the elderly surgical patient has resulted in a “call to action” from experts in this area. A paradigm shift will be necessary to make this screening routine and not just a research tool. We describe our preliminary experience with developing a training program and implementing routine cognitive screening in a preoperative evaluation clinic. We outline a process showing our successful clinical implementation of sustainable cognitive stratification and documentation of routine cognitive screening.

From the *University of Chicago, Chicago, Illinois

Departments of Anesthesiology, Perioperative and Pain Medicine

Surgery, Brigham Health, Boston, Massachusetts

§Division of Aging, Department of Medicine, Brigham Health, Boston, Massachusetts.

Accepted for publication August 1, 2018.

Funding: This study was in part funded by the John A. Hartford Foundation.

The authors declare no conflicts of interest.

Institutional review board: Approved by Partners Institutional Review Board.

Mini-Cog© is available at: (Copyright: S. Borson).

Address correspondence to Angela M. Bader, MD, MPH, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115. Address e-mail to

© 2019 International Anesthesia Research Society
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