- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06030765
Detect CI (Cognitive Impairment) Study (CI)
Evaluation of Rapid Cognitive Screening Tools for Detection of Cognitive Impairment in Older Surgical Patients: A Prospective Cohort Study - Detect CI Study
Study Overview
Status
Conditions
Detailed Description
The primary aims of the study is to (1) determine the diagnostic accuracy (sensitivity, specificity, and the AUC) of two rapid cognitive screening tools (AD8 and Mini-Cog) against the MoCA in the older surgical population and (2) determine the prevalence of CI as detected by the cognitive screening tests (AD8, Mini-Cog, or MoCA) and to determine the prevalence of elevated plasma biomarkers associated with neurodegenerative and/or vascular diseases using plasma (pTau181 or NfL) biomarkers in those with CI as detected by the screening tools. The secondary aims are to (1) describe the distribution of plasma pTau181 or NfL biomarkers in patients meeting the CI criteria by the AD8, Mini-Cog, or MoCA, (2) compare the trajectory of patient-reported outcomes at baseline, 30-, and 90-day post-surgery in patients with or without CI as detected by the cognitive screening tests, and (3) compare clinical outcomes in patients with or without CI as detected by the cognitive screening tests.
The study consists of four consecutive time points, including one preoperative assessment and three postoperative assessments occurring during participants' hospital stay and at 30- and 90-day post-surgery. In the preoperative assessment 1-30 days before their scheduled surgery, patients will be asked to complete the AD8, Mini-Cog, MoCA and the STOP-Bang Questionnaire in-person. If a patient screens positive on one or more of the three cognitive screening tools, they will have blood drawn for pTau181 and NfL bioassay analysis. Additionally, patients will be asked to complete the following assessments via an online survey or over the telephone prior to their scheduled surgery: WHODAS-2.0 (World Health Organization Disability Assessment Schedule 2.0), 5-item FRAIL Questionnaire, PHQ-4 (4-Item Patient Health Questionnaire for Anxiety and depression), VAS (visual analog scale) pain, SQS (Single Item Sleep Quality Scale), and a single question on QoL (quality of life).
The first postoperative time point will occur during participants' stay at the hospital in which postoperative delirium (POD), postoperative complications, length of stay (LOS), and discharge destination will be assessed. At 30- and 90-day postoperatively, chart review will be performed to assess clinical outcomes, such as postoperative complications, all-cause mortality, and hospital readmission. Patient-reported outcomes, including WHODAS 2.0, 5-item FRAIL Questionnaire, PHQ-4, VAS pain, and QoL, will also be assessed through an online survey or over the telephone.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Sazzadul Islam
- Phone Number: 4166622686
- Email: sazzadul.islam@uhn.ca
Study Locations
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Ontario
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Toronto, Ontario, Canada
- Recruiting
- Mount Sinai Hospital
-
Contact:
- Sazzadul Islam
- Phone Number: 14166622686
- Email: sazzadul.islam@uhn.ca
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Principal Investigator:
- David He, MD PhD FRCPC
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Toronto, Ontario, Canada, M5T2S8
- Recruiting
- 399 Bathurst St., Toronto Western Hospital, Dept. of Anesthesia
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Principal Investigator:
- Frances Chung, MBBS FRCPC
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Contact:
- Sazzadul Islam, M.Sc.
- Phone Number: 416 662 2686
- Email: sazzadul.islam@uhn.ca
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- patients ≥ 65 years old;
- competent to provide informed consent in English;
- undergoing elective non-cardiac surgery;
- education ≥ 8 years;
- able to be contacted by telephone.
Exclusion Criteria:
- previous neurocognitive disorder (e.g., dementia) diagnosis;
- uncontrolled psychiatric disorders;
- hearing and/or vision impairment;
- unable to write or hold pen;
- undergoing neurosurgery;
- unable to provide informed consent.
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The diagnostic accuracy (sensitivity, specificity, and AUC)
Time Frame: Pre-surgery
|
The diagnostic accuracy (sensitivity and specificity) of the AD8 (Eight-item Interview to Differentiate Aging and Dementia) and Mini-Cog against the MoCA (Montreal Cognitive Assessment).
|
Pre-surgery
|
The diagnostic accuracy (sensitivity, specificity, and AUC)
Time Frame: Pre-surgery
|
The AUC (Area under the Receiver Operating Characteristic Curve (ROC)) of the AD8 (Eight-item Interview to Differentiate Aging and Dementia) and Mini-Cog against the MoCA (Montreal Cognitive Assessment).
|
Pre-surgery
|
Prevalence of cognitive impairment (CI) via cognitive screening tools
Time Frame: Pre-surgery
|
The prevalence of CI as detected by the AD8 (Eight-item Interview to Differentiate Aging and Dementia).
The AD8 is scored from 0-8 with a score of two or more indicating cognitive impairment.
|
Pre-surgery
|
Prevalence of cognitive impairment (CI) via cognitive screening tools
Time Frame: Pre-surgery
|
The prevalence of CI as detected by the Mini-Cog.
The Mini-Cog is scored from 0-5 with a score of two or less indicating cognitive impairment.
|
Pre-surgery
|
Prevalence of cognitive impairment (CI) via cognitive screening tools
Time Frame: Pre-surgery
|
The prevalence of CI as detected by the MoCA (Montreal Cognitive Assessment).
The MoCA is scored from 0-30 with a score of 25 or less indicating cognitive impairment.
|
Pre-surgery
|
Prevalence of elevated plasma biomarkers
Time Frame: Pre-surgery
|
The prevalence of elevated plasma biomarkers associated with neurogenerative and/or vascular diseases using plasma pTau181 biomarkers in those with CI as detected by the screening tools.
|
Pre-surgery
|
Prevalence of elevated plasma biomarkers
Time Frame: Pre-surgery
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The prevalence of elevated plasma biomarkers associated with neurogenerative and/or vascular diseases using plasma NfL biomarkers in those with CI as detected by the screening tools.
|
Pre-surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Distribution of plasma biomarkers
Time Frame: Pre-surgery
|
The distribution of plasma pTau181 biomarkers in patients meeting the CI criteria by the cognitive screening tools.
|
Pre-surgery
|
Distribution of plasma biomarkers
Time Frame: Pre-surgery
|
The distribution of plasma NfL biomarkers in patients meeting the CI criteria by the cognitive screening tools.
|
Pre-surgery
|
Trajectories and prevalence or incidence of patient-reported outcomes pre-surgery
Time Frame: Pre-surgery, 30- and 90-days post-surgery
|
The trajectory and prevalence or incidence of functional disability as measured through the WHODAS 2.0 (World Health Organization Disability Assessment Schedule 2.0) in participants with CI vs those without.
A five-point rating scale is used for each question (none = 0, mild = 1, moderate = 2, severe = 3, extreme/cannot do = 4), and a higher WHODAS score indicates greater disability.
|
Pre-surgery, 30- and 90-days post-surgery
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Trajectories and prevalence or incidence of patient-reported outcomes pre-surgery
Time Frame: Pre-surgery, 30- and 90-days post-surgery
|
The trajectory and prevalence or incidence of frailty as measured through the 5-item FRAIL questionnaire in participants with CI vs those without.
It is scored from 0-5 where higher scores indicate frailty.
|
Pre-surgery, 30- and 90-days post-surgery
|
Trajectories and prevalence or incidence of patient-reported outcomes pre-surgery
Time Frame: Pre-surgery, 30- and 90-days post-surgery
|
The trajectory and prevalence or incidence of pain as measured through the VAS Pain (Visual Analog Scale for Pain) in participants with CI vs those without.
It is scored from 0-10 where a lower score indicates worse pain.
|
Pre-surgery, 30- and 90-days post-surgery
|
Trajectories and prevalence or incidence of patient-reported outcomes pre-surgery
Time Frame: Pre-surgery, 30- and 90-days post-surgery
|
The trajectory and prevalence or incidence of depression and anxiety as measured through the PHQ-4 (4-Item Patient Health Questionnaire) in participants with CI vs those without.
It is scored from 0-12 where a higher score indicates depression and anxiety.
|
Pre-surgery, 30- and 90-days post-surgery
|
Trajectories and prevalence or incidence of patient-reported outcomes pre-surgery
Time Frame: Pre-surgery
|
The trajectory and prevalence or incidence of obstructive sleep apnea (OSA) as measured through the STOP-Bang Questionnaire in participants with CI vs those without.
It is scored from 0-8 where a higher score indicates higher risk for OSA.
|
Pre-surgery
|
Trajectories and prevalence or incidence of patient-reported outcomes pre-surgery
Time Frame: Pre-surgery
|
The trajectory and prevalence or incidence of sleep disturbances as measured through the SQS (Single Item Sleep Quality Scale) in participants with CI vs those without.
It is scored from 0-10 where a lower score indicates sleep disturbances.
|
Pre-surgery
|
Trajectories and prevalence or incidence of patient-reported outcomes pre-surgery
Time Frame: Pre-surgery, 30- and 90-days post-surgery
|
The trajectory and prevalence or incidence of quality of life as measured through the single question on Quality of Life (QoL) in participants with CI vs those without.
It is scored from 0-100 where a lower score indicates worse quality of life.
|
Pre-surgery, 30- and 90-days post-surgery
|
Clinical outcomes post-surgery
Time Frame: 1-3 days post-surgery
|
The incidence of postoperative delirium as assessed by the Confusion Assessment Method (CAM) conducted by the nursing team and through medical chart review.
|
1-3 days post-surgery
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Clinical outcomes post-surgery
Time Frame: 1-3 days post-surgery
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Postoperative complications
|
1-3 days post-surgery
|
Clinical outcomes post-surgery
Time Frame: 1-3 days post-surgery
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Hospital length of stay (LOS)
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1-3 days post-surgery
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Clinical outcomes post-surgery
Time Frame: 1-3 days post-surgery
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Discharge destination (assess where the participant will be discharged to once out of hospital up to 30-days post-op)
|
1-3 days post-surgery
|
Clinical outcomes post-surgery
Time Frame: 30- and 90-days post-surgery
|
Mortality
|
30- and 90-days post-surgery
|
Clinical outcomes post-surgery
Time Frame: 30- and 90-days post-surgery
|
Readmission
|
30- and 90-days post-surgery
|
Clinical outcomes post-surgery
Time Frame: 30- and 90-days post-surgery
|
Postoperative complications
|
30- and 90-days post-surgery
|
Collaborators and Investigators
Investigators
- Principal Investigator: Frances Chung, MBBS FRCPC, University Health Network, Toronto
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 22-5810
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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