{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T18:49:26Z","timestamp":1788634166504,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,1,13]],"date-time":"2018-01-13T00:00:00Z","timestamp":1515801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100001405","name":"Brookdale Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001405","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HL109971"],"award-info":[{"award-number":["HL109971"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To compare postoperative outcomes of individuals with and without cognitive impairment enrolled in the Perioperative Optimization of Senior Health (\n                      <jats:styled-content style=\"fixed-case\">POSH<\/jats:styled-content>\n                      ) program at Duke University, a comanagement model involving surgery, anesthesia, and geriatrics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective analysis of individuals enrolled in a quality improvement program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary academic center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Older adults undergoing surgery and referred to\n                      <jats:styled-content style=\"fixed-case\">POSH<\/jats:styled-content>\n                      (N = 157).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>\n                      Cognitive impairment was defined as a score less than 25 out of 30 (adjusted for education) on the St. Louis University Mental Status (\n                      <jats:styled-content style=\"fixed-case\">SLUMS<\/jats:styled-content>\n                      ) Examination. Median length of stay (\n                      <jats:styled-content style=\"fixed-case\">LOS<\/jats:styled-content>\n                      ), mean number of postoperative complications, rates of postoperative delirium (\n                      <jats:styled-content style=\"fixed-case\">POD<\/jats:styled-content>\n                      , %), 30\u2010day readmissions (%), and discharge to home (%) were compared using bivariate analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy percent of participants met criteria for cognitive impairment (mean\n                      <jats:styled-content style=\"fixed-case\">SLUMS<\/jats:styled-content>\n                      score 20.3 for those with cognitive impairment and 27.7 for those without). Participants with and without cognitive impairment did not significantly differ in demographic characteristics, number of medications (including anticholinergics and benzodiazepines), or burden of comorbidities. Participants with and without cognitive impairment had similar\n                      <jats:styled-content style=\"fixed-case\">LOS<\/jats:styled-content>\n                      (\n                      <jats:italic>P<\/jats:italic>\n                      = .99), cumulative number of complications (\n                      <jats:italic>P<\/jats:italic>\n                      = .70), and 30\u2010day readmission (\n                      <jats:italic>P<\/jats:italic>\n                      = .20).\n                      <jats:styled-content style=\"fixed-case\">POD<\/jats:styled-content>\n                      was more common in those with cognitive impairment (31% vs 24%), but the difference was not significant (\n                      <jats:italic>P<\/jats:italic>\n                      = .34). Participants without cognitive impairment had higher rates of discharge to home (80.4% vs 65.1%,\n                      <jats:italic>P<\/jats:italic>\n                      = .05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Older adults with and without cognitive impairment referred to the\n                      <jats:styled-content style=\"fixed-case\">POSH<\/jats:styled-content>\n                      program fared similarly on most postoperative outcomes. Individuals with cognitive impairment may benefit from perioperative geriatric comanagement. Questions remain regarding the validity of available measures of cognition in the preoperative period.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.15261","type":"journal-article","created":{"date-parts":[[2018,1,13]],"date-time":"2018-01-13T21:46:34Z","timestamp":1515879994000},"page":"584-589","source":"Crossref","is-referenced-by-count":24,"title":["Preoperative Cognitive Impairment As a Predictor of Postoperative Outcomes in a Collaborative Care Model"],"prefix":"10.1111","volume":"66","author":[{"given":"Kahli","family":"Zietlow","sequence":"first","affiliation":[{"name":"Division of Geriatrics Department of Internal Medicine Duke University Health Systems Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley R.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Division of Geriatrics Department of Internal Medicine Duke University Health Systems Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Sloane","sequence":"additional","affiliation":[{"name":"Center for Aging Duke University Health Systems Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Browndyke","sequence":"additional","affiliation":[{"name":"Division of Geriatric Behavioral Health Department of Psychiatry Duke University Health Systems Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandhya","family":"Lagoo\u2010Deenadayalan","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University Health Systems Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell T.","family":"Heflin","sequence":"additional","affiliation":[{"name":"Division of Geriatrics Department of Internal Medicine Duke University Health Systems Durham North Carolina"},{"name":"Center for Aging Duke University Health Systems Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.4573"},{"key":"e_1_2_6_3_1","unstructured":"OrtmanJM VelkoffVA HoganH.An Aging Nation: The Older Population in the United States (Report P25\u20131140) [on\u2010line]. 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