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In this prospective cohort study, 50 patients aged 65 years and older scheduled for AVR between January and October 2022 underwent preoperative assessment with the Brain Aging Monitor Cognitive Assessment (BAMCOG) and Montreal Cognitive Assessment (MoCA). Postoperatively, POD was evaluated with the Delirium Observation Screening (DOS) scale and POE with electroencephalography (EEG). BAMCOG and MoCA showed poor accuracy in predicting POE, with AUROC values of 0.67 and 0.59 respectively, but BAMCOG demonstrated good accuracy for POD prediction (AUROC 0.85) compared with MoCA (AUROC 0.53). Higher BAMCOG scores were significantly associated with reduced POD incidence, with each 10% increase in score lowering the risk by 16%. These findings suggest that BAMCOG may be a valuable preoperative screening tool for POD, though larger studies are needed to confirm its clinical utility and establish optimal cutoff values.<\/jats:p>","DOI":"10.1371\/journal.pdig.0001005","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T17:41:02Z","timestamp":1757353262000},"page":"e0001005","update-policy":"https:\/\/doi.org\/10.1371\/journal.pdig.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluating the predictive accuracy of cognitive screeners BAMCOG and MoCA in identifying postoperative delirium risk in aortic valve replacement patients: A cohort study"],"prefix":"10.1371","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4841-3130","authenticated-orcid":true,"given":"Mariska E.","family":"te Pas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Adelaars","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. 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Preliminary study","volume":"52","author":"N Soko\u0142owska","year":"2018","journal-title":"Psychiatr Pol"},{"key":"pdig.0001005.ref020","unstructured":"Unity. Game development software: Create 2D & 3D games. https:\/\/unity.com\/games. 2024 February 26."},{"issue":"9","key":"pdig.0001005.ref021","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1016\/j.jagp.2023.12.005","article-title":"DeltaScan for the Assessment of Acute Encephalopathy and Delirium in ICU and non-ICU Patients, a Prospective Cross-Sectional Multicenter Validation Study","volume":"32","author":"FL Ditzel","year":"2024","journal-title":"Am J Geriatr Psychiatry"},{"issue":"12","key":"pdig.0001005.ref022","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1111\/pcn.13478","article-title":"An automated electroencephalography algorithm to detect polymorphic delta activity in acute encephalopathy presenting as postoperative delirium","volume":"76","author":"FL Ditzel","year":"2022","journal-title":"Psychiatry Clin Neurosci"},{"issue":"1","key":"pdig.0001005.ref023","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1891\/rtnp.17.1.31.53169","article-title":"The Delirium Observation Screening Scale: a screening instrument for delirium","volume":"17","author":"MJ Schuurmans","year":"2003","journal-title":"Res Theory Nurs Pract"},{"key":"pdig.0001005.ref024","volume-title":"Intelligentie en leeftijd bij volwassenen en bejaarden","author":"F Verhage","year":"1964"},{"issue":"3","key":"pdig.0001005.ref025","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1308\/rcsann.2011.93.3.185a","article-title":"The ASA classification and peri-operative risk","volume":"93","author":"J Fitz-Henry","year":"2011","journal-title":"Ann R Coll Surg Engl"},{"issue":"11","key":"pdig.0001005.ref026","doi-asserted-by":"crossref","DOI":"10.1111\/jgs.14428","article-title":"A Simple Tool to Predict Development of Delirium After Elective Surgery","volume":"64","author":"A Dworkin","year":"2016","journal-title":"J Am Geriatr Soc"},{"key":"pdig.0001005.ref027","doi-asserted-by":"crossref","first-page":"359","DOI":"10.2147\/CIA.S350195","article-title":"Prediction of Postoperative Delirium After Cardiac Surgery with A Quick Test of Cognitive Speed, Mini-Mental State Examination and Hospital Anxiety and Depression Scale","volume":"17","author":"A Segern\u00e4s","year":"2022","journal-title":"Clin Interv Aging"},{"issue":"1","key":"pdig.0001005.ref028","doi-asserted-by":"crossref","first-page":"21090","DOI":"10.1038\/s41598-023-48418-5","article-title":"Development of postoperative delirium prediction models in patients undergoing cardiovascular surgery using machine learning algorithms","volume":"13","author":"C Nagata","year":"2023","journal-title":"Sci Rep"},{"issue":"3","key":"pdig.0001005.ref029","doi-asserted-by":"crossref","DOI":"10.2196\/18644","article-title":"The Effects of Gamification on Computerized Cognitive Training: Systematic Review and Meta-Analysis","volume":"8","author":"JF Vermeir","year":"2020","journal-title":"JMIR Serious Games"},{"key":"pdig.0001005.ref030","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.invent.2016.10.002","article-title":"Gamification for health and wellbeing: A systematic review of the literature","volume":"6","author":"D Johnson","year":"2016","journal-title":"Internet Interv"},{"issue":"11","key":"pdig.0001005.ref031","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1007\/s11920-023-01453-5","article-title":"Gamification: a Novel Approach to Mental Health Promotion","volume":"25","author":"C Cheng","year":"2023","journal-title":"Curr Psychiatry Rep"},{"issue":"4","key":"pdig.0001005.ref032","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.ejcnurse.2009.02.006","article-title":"The delirium observation screening scale recognizes delirium early after cardiac surgery","volume":"8","author":"S Koster","year":"2009","journal-title":"Eur J Cardiovasc Nurs"},{"issue":"7","key":"pdig.0001005.ref033","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1002\/jhm.2580","article-title":"Validation of the delirium observation screening scale in a hospitalized older population","volume":"11","author":"K Gavinski","year":"2016","journal-title":"J Hosp Med"},{"issue":"9","key":"pdig.0001005.ref034","doi-asserted-by":"crossref","first-page":"1932","DOI":"10.1111\/jgs.14933","article-title":"Recognition of Delirium in Postoperative Elderly Patients: A Multicenter Study","volume":"65","author":"T Numan","year":"2017","journal-title":"J Am Geriatr Soc"},{"key":"pdig.0001005.ref035","unstructured":"Meetinstrumenten voor screening en diagnostiek van delier. Richtlijnendatabase. https:\/\/richtlijnendatabase.nl\/richtlijn\/delier_bij_volwassenen_en_ouderen_2023\/meetinstrumenten_voor_screening_en_diagnostiek_van_delier.html. 2023. 2024 October 8."},{"issue":"4","key":"pdig.0001005.ref036","article-title":"Delirium diagnosis without a gold standard: Evaluating diagnostic accuracy of combined delirium assessment tools","volume":"17","author":"SJ Moss","year":"2022","journal-title":"PLoS One"},{"key":"pdig.0001005.ref037","doi-asserted-by":"crossref","first-page":"102025","DOI":"10.1016\/j.arr.2023.102025","article-title":"Delirium assessment tools among hospitalized older adults: A systematic review and metaanalysis of diagnostic accuracy","volume":"90","author":"C-J Lin","year":"2023","journal-title":"Ageing Res Rev"},{"key":"pdig.0001005.ref038","doi-asserted-by":"crossref","first-page":"111896","DOI":"10.1016\/j.jclinane.2025.111896","article-title":"Incidence of delirium post cardiac surgery: Discrepancy between clinical observation, DOS scores, and single\u2011lead EEG","volume":"106","author":"S Adelaars","year":"2025","journal-title":"J Clin Anesth"},{"issue":"3","key":"pdig.0001005.ref039","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1002\/gps.2526","article-title":"Assessing severity of delirium by the Delirium Observation Screening Scale","volume":"26","author":"AC Scheffer","year":"2011","journal-title":"Int J Geriatr Psychiatry"},{"issue":"1","key":"pdig.0001005.ref040","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1186\/s12984-025-01665-1","article-title":"Validity and usability for digital cognitive assessment tools to screen for mild cognitive impairment: a randomized crossover trial","volume":"22","author":"M Wu","year":"2025","journal-title":"J Neuroeng Rehabil"},{"issue":"1","key":"pdig.0001005.ref041","doi-asserted-by":"crossref","DOI":"10.1186\/s44247-024-00123-7","article-title":"Usability of an at-home tablet-based cognitive test in older adults with and without cognitive impairment","volume":"2","author":"TA Bayer","year":"2024","journal-title":"BMC Digit Health"},{"issue":"12","key":"pdig.0001005.ref042","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.3390\/brainsci13121682","article-title":"Delirium after Cardiac Surgery-A Narrative Review","volume":"13","author":"D Mattimore","year":"2023","journal-title":"Brain Sci"},{"issue":"8","key":"pdig.0001005.ref043","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1177\/02676591221119312","article-title":"Neurologic complications after cardiopulmonary bypass - A narrative review","volume":"38","author":"T Gilbey","year":"2023","journal-title":"Perfusion"},{"issue":"1","key":"pdig.0001005.ref044","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s12877-020-1449-8","article-title":"Incidence of and risk factors for postoperative delirium in older adult patients undergoing noncardiac surgery: a prospective study","volume":"20","author":"A Iamaroon","year":"2020","journal-title":"BMC Geriatr"}],"container-title":["PLOS Digital Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pdig.0001005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T17:41:21Z","timestamp":1757353281000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pdig.0001005"}},"subtitle":[],"editor":[{"given":"Peter H","family":"Charlton","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,9,8]]},"references-count":44,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9,8]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pdig.0001005","relation":{},"ISSN":["2767-3170"],"issn-type":[{"value":"2767-3170","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,8]]}}}