The American College of Surgeons and the American Geriatrics Society have suggested that preoperative cognitive screening should be performed in older surgical patients. In this issue of Anesthesiology, Culley et al. cognitively screened 211 patients aged 65 yr old or older without a diagnosis of dementia who were scheduled for an elective hip or knee replacement. Many older elective orthopedic surgical patients were found to have probable cognitive impairment preoperatively. This impairment was associated with development of delirium postoperatively, a longer hospital stay, and lower likelihood of going home upon hospital discharge.

  • Culley et al.: Poor Performance on a Preoperative Cognitive Screening Test Predicts Postoperative Complications in Older Orthopedic Surgical Patients, p. 765