The Co-TELE-SURGE study: A prospective cohort proof-of-concept study of perioperative cognitive trajectories in older adults undergoing noncardiac surgery.

Authors

Maram Khaled, Rachel Gutschon, Varunkumar Bathini, Paul Martin, Hazem Elmansy, P J Devereaux, Maria Tiboni, John Harlock, Aleksa Cenic, Niv Sne, Yaron Shargall, Rahima Nenshi, Harsha Shanthanna, Lehana Thabane, Federico Germini, Michael Korstensky, Neeloufar Grami, Asher Selznick, Colette van Dyk, Lekhini Latchupatula, Myles Benayon, Anabela Cotovio, Allisson Hoffman, Caroline Hircock, Hannah Yaremko, Olsen Chan, Michael Dennis, Emanuele Blasioli, Denise Sabac, Annika Sharma, Kevin Krysiak, Peter Huan, Shyla Gupta, Flavia K Borges, Sandra Ofori, Silvia Maiorano, Michela Barisone, Yetiani Roldan, Michael Sevestre, Mary Ferber, Francesca Mulazzani, Jessica Spence, Philippe D Violette, Maura Marcucci

Published in

Journal of clinical anesthesia. Volume 115. Pages 112326. Sep 22, 2026. Epub Sep 22, 2026.

Abstract

There is evidence that older patients experience cognitive changes after surgery compared to before. Most existing studies compare postoperative cognitive performance to the performance at a single preoperative timepoint. Therefore, it is unclear whether postoperative changes are a result of surgery or would have been expected as a continuation of a preoperative trend.
To explore the impact of surgery on perioperative cognitive trajectories, among ≥65 years old patients waiting for ≥6 weeks before undergoing elective noncardiac surgery during the COVID-19 pandemic.
In this proof-of-concept prospective study, cognitive performance of participants was assessed remotely at enrolment, monthly preoperatively (≥2 assessments) and at 1, 3, 6, and 12 months postoperatively, using the Cogstate Brief Battery. The association of surgery with cognitive changes was analyzed using an interrupted time-series approach.
In the 84 included participants, after controlling for the preoperative trend, surgery resulted in a small decline in the level of average performance on tasks assessing psychomotor function and attention from before to after surgery (p = 0.017). Postoperative trajectories showed improvement compared to preoperative ones in the psychomotor function (p = 0.008), attention (p = 0.002) and visual learning (p = 0.007). After adjusting for potential confounders, only the postoperative level change in attention remained statistically significant (p = 0.027).
In our exploratory proof-of-concept study, surgery was associated with a statistically significant level and trend change in cognitive performance, however the magnitude of the change was small and partially due to confounding. Further research with adequate power is needed to confirm our findings and elucidate factors associated with postoperative cognitive decline.
clinicaltrials.govNCT04787536.

PMID:
42790141
Bibliographic data and abstract were imported from PubMed on 26 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.