Domain-Specific Subjective Cognitive complaints and Cognitive Test Performance After Surgery in Older Adults: A Patient-Centered Prospective Cohort Study.

Authors

Brian J Lilienstein, Laura P Sands, Serena Padda, Jacqueline M Leung, Perioperative Medicine Research Group

Published in

The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. Sep 10, 2026. Epub Sep 10, 2026.

Abstract

Subjective cognitive complaints are clinically important in the assessment of perioperative neurocognitive changes because current nomenclature incorporates cognitive concerns reported by patients or others. However, the relationship between patients' subjective cognitive complaints and contemporaneous changes in cognitive test performance during the immediate postoperative period remains poorly understood.
To identify if subjective cognitive complaints reported before hospital discharge were associated with cognitive changes measured with cognitive tests.
Prospective cohort study.
Patients aged ≥65 years undergoing elective noncardiac surgery.
Pre- and postoperatively for the first three days daily, patients' cognitive function was measured by the timed Verbal Fluency test, the Word List learning task, and Digit Span Backward to assess the cognitive domains of memory and learning (Word List), executive function (Verbal Fluency), attention and working memory (Digit Span Backward and Word List), and language (verbal fluency). Patient's subjective opinion of cognition was measured by the Subjective Cognitive Questionnaire (SCQ). The SCQ statements were matched to Word List; Verbal Fluency; and Digit Span Backwards respectively. Logistic regression analyses were performed for each pairing. Sensitivity, specificity, and receiver operating characteristic (ROC) curves were derived. Postoperative delirium was measured daily using the Confusion Assessment Method for the first 3 postoperative days.
About 197 patents were recruited and 10 excluded because of incomplete SCQ responses or missing delirium assessments. Subjective cognitive complaints were associated with objective decline on the following cognitive tests: Word List (OR 1.31, 95% CI 1.07-1.60; p = 0.008), Verbal Fluency (OR 1.79, 95% CI 1.37-2.34; p <0.0001), and Digit Span Backwards (OR 5.15, 95% CI 1.86-13.54, p = 0.001). Discrimination was poor to moderate (AUC 0.52-0.66), with generally higher specificity but low sensitivity.
Subjective cognitive complaints were associated with objective perioperative cognitive decline. Patient-reported symptoms may reflect early cognitive vulnerability, however, subjective cognitive complaints showed low sensitivity, limiting their utility as standalone screening tools.

PMID:
42855369
Bibliographic data and abstract were imported from PubMed on 10 Oct 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.