DIAGNOSTIC CRITERIA FOR POST-OPERATIVE COGNITIVE DYSFUNCTION: LITERATURE REVIEW

Abstract

Introduction. Postoperative cognitive dysfunction (POCD) is characterized by deterioration of cognitive performances (learning, memory, focusing) that appears after anesthesia and surgery, Moller J. et al., 1998 [1]. For the first time, POCD was described in elderly persons in 1955 by Bedford P [2]. The peculiarity of the cognitive system is its complexity that requires a large variety of questionnaires in order to asses POCD. An ideal test or a unification of questionnaires has not been made yet. Thus, the proposed questionnaires need to be standardized and validated for POCD assessment with further proof of its utility and applicability. Material and methods. Relevant articles have been searched in PubMed using the following key words: postoperative cognitive dysfunction, diagnostic criteria, assessment and evaluation. Articles from the last 15 years have been submitted for analysis. Results. A number of 296 of articles have been identified, according to inclusion criteria, out of them, 10 articles were subject of final analysis. In the published articles, 24 questionnaires regarding POCD assessment were found. Thereby, Mini-Mental State Examination, Grooved pegboard test (preferred hand) and Grooved pegboard test (non dominant) were used in 6 studies [12–14; 16; 18–20]. Two questionnaires (STROOP — Stroop colour word difference test and DSST-digit symbol substitution test) were applied in 5 studies [11; 13–16; 18–20]. The TNM questionnaire was used in 4 researches [12–14; 19]. The Visual Verbal Learning test, concept shifting test, letter digit coding, Digit Span Test were all identified in 3 articles [11; 13; 15; 18–20]. Two researches contain the following questionnaires: Rey’s auditorial verbal learning test (RAVLT), Rey’s auditorial verbal learning test long-term memory (RAVLT-LT), verbal fluency test (VFT), visual verbal learning test (VVL), controlled oral word association test, consortium to establish a registry for Alzheimer’s [13; 14; 16; 18]. Eight questionnaires were used by a single research: Word Learning Task, Auditory Verbal Leaning Test Digit, Disease verbal fluency-animals, Examen Cognitif par Ordinateur (ECO), Deterioration Cognitive Observee (DECO), Mental Control, Visual retention, Paired- Associate verbal learning [14; 16; 17; 19]. According to different authors, POCD varies between 3.1% and 52%. Conclusions. A big variety of questionnaires used in POCD appreciation leads to ambiguity in its diagnosis.