Screening cognitive dysfunction

♦ It is important to screen for cognitive dysfunction prior to surgery.

♦ There is no clear definition about what is acceptable cognition to become a surgical candidate.

♦ Patients who are getting lost or disorientated in general are not good candidates for surgery.

♦ Patients with moderate to severe frontal and memory dysfunction may not be good candidates.

♦ Patients with an MMSE score of <26, or a Mattis DRS <116 in general may not be good candidates for surgery.

♦ It is recommended that neuropsychological testing be done prior to surgery. A typical neuropsychological battery is shown in 104.

♦ The neuropsychological screening may need to be repeated after surgery especially if cognitive decline is apparent (it is useful to have baseline testing for comparison in this situation).

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