International publications validate Cogstate technology’s clinical value in detecting Postoperative Cognitive Dysfunction (POCD)
February 12, 2018
BOSTON – February 13, 2017: From the Interdisciplinary Conference on Orthopedic Value Based Care sponsored by the American College of Perioperative Medicine, Cogstate announced that the Cogstate Brief BatteryTM has now been shown to be useful for guiding decision making about cognitive outcomes in older adults awaiting or undergoing surgery. Cogstate Brief Battery is the proprietary technology utilized in the company’s CognigramTM digital cognitive assessment system, which is used extensively in the clinical assessment of dementia and concussion.
In the December 2017 issue of Frontiers in Aging Neuroscience, clinicians and researchers associated with Tohoku University and Fujita Health University in Japan published a peer-reviewed paper titled “Indication of Cognitive Change and Associated Risk Factor after
Thoracic Surgery in the Elderly: A Pilot Study” (Kulason et al., Volume 9, Article 396). In this pilot study, authors examined cognitive changes after major thoracic surgery utilizing the Cogstate Brief Battery, the Mini-Mental State Examination (MMSE), and Frontal Assessment Battery, and found significant association between Cogstate results and patients’ actual clinical status.
In this study, where cognition was measured by the Cogstate Brief Battery, older adults showed a post-surgery cognitive decline, and the magnitude of this post-surgical decline was associated significantly with anesthetic duration (p=0.012). Furthermore, post-surgical cognition was associated positively with ratings of pre-surgical psychiatric well-being measured using the General Health Questionnaire scores (GHQ-12). Interestingly, no cognitive changes with surgery were detected by the MMSE. The researchers concluded that “…it is possible to detect declines in two different [Cogstate] domains, processing speed and visual attention, 1 week after surgery”.
“There is growing global awareness about brain health complications after surgery in older adults. As many as 50-65% of older patients undergoing surgery suffer from post-operative delirium or cognitive dysfunction, which can lead to higher mortality, prolonged hospital stays or hospital re-admissions, and long-term cognitive impairment. These complications dramatically increase the economic burden to payors, providers and families,” said Frank Cheng, President of Cogstate Healthcare. “Cogstate has been actively involved in the research to understand perioperative brain health management for more than ten years. We are encouraged by the growing body of positive clinical evidence confirming the utility of the Cognigram system to detect and predict POCD and other post-surgical brain health complications.”
To improve brain health management in geriatric surgery, the American Society of Anesthesiologists (ASA) has recently started its Perioperative Brain Health Initiative. Similarly, the American College of Surgeons (ACS) is supporting The Coalition for Quality in Geriatric Surgery Project together with the John A. Hartford Foundation. These organizations, as well as the American Geriatrics Society (AGS), now recommend proactive cognitive testing before and after geriatric surgery.
This recent study from Frontiers in Aging Neuroscience adds to a growing series of peer-reviewed scientific publications that demonstrate the validity and utility of the Cognigram system in surgical programs. These publications include:
- British Journal of Anaesthesia published “Detection of Cognitive Decline After Coronary Surgery: A Comparison of Computerized and Conventional Tests” authored in 2004 by a team from St. Vincent’s Hospital, Melbourne, Australia. In this study of 100 patients, authors compared Cogstate results with those from six conventional neuropsychology tests, and found that the Cogstate computerized tests were more reliable than the conventional tests, and exhibited high sensitivity and specificity when detecting POCD. The authors concluded “computerized tests are suitable for measuring cognitive change after [Coronary Artery Bypass Graft] CABG surgery, are easy to administer and analyze, and may detect change in a greater proportion of patients 6 days after CABG surgery than conventional neuropsychological tests.”
- The official journal of the Japan Neurosurgical Society, Neurologia Medico-Chirurgica published “Assessment of Cognitive Function Before and After Surgery for Posterior Cranial Fossa Lesions Using Computerized and Conventional Tests” authored in 2010 by researchers at Keio University School of Medicine, Tokyo, Japan. In this study of 50 surgical patients, authors compared Cogstate results with those from conventional neuropsychology tests (Serial Seven-Word Learning Test and MMSE). Authors reported that the Cogstate computerized test was very sensitive in detecting POCD, efficient to administer, and was free of undesirable practice effects. Authors concluded “The [Cogstate] computerized tests could be performed easily and were beneficial for detecting subtle changes of the cognitive function after surgery.”
The Cognigram system is a digital cognitive assessment tool that provides rapid assessment of cognition that can be completed both in-clinic and at-home. It was reviewed by the FDA in 2017 and was authorized to be marketed in the U.S. It is for prescription use, and is intended to aid healthcare professionals with an objective measurement of cognition for use in individuals aged 6 – 99 years old. The Cognigram system can be used to assess cognition on a single occasion or cognitive change over periodic assessments. Performance on the Cognigram system is unaffected by language, education, cultural background, or by undesirable practice effects.