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Few Anesthesiologists Screen Elderly for Frailty, Dementia

Most anesthesiologists report that preop, postop screening occurs in less than 10 percent of cases

TUESDAY, March 17, 2020 (HealthDay News) — Few U.S. anesthesiologists report preoperative screening for frailty or dementia or postoperative screening for delirium among older adults, according to a study published online Feb. 25 in Perioperative Medicine.

Stacie Deiner, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues administered a web-based questionnaire to examine adherence by U.S. anesthesiologists to specific practices for perioperative care of older adults. A total of 1,737 American Society of Anesthesiology members answered at least one item.

The researchers found that 96.4 percent of respondents reported having cared for a patient aged ≥65 years in the previous year. Use of multimodal analgesia among patients aged ≥65 years at least 90 percent of the time was reported by 47.1 percent of respondents, while 25.5 percent provided preoperative information regarding risk for postoperative cognitive changes at least 90 percent of the time. More than 80 percent of respondents reported that in less than 10 percent of cases, there was preoperative screening for frailty or dementia, postoperative screening for delirium, or preoperative geriatric consultation. The most frequently prioritized initiatives to improve care in this domain were development of practice guidelines for geriatric anesthesia care and expansion of web-based resources.

“Patients with cognitive impairment and frailty can have better recovery and fewer complications if the condition is recognized and used to tailor their perioperative care,” Deiner said in a statement.

Deiner disclosed financial ties to Merck and Covidien and has received payment as a legal expert witness.

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