Assessment of a digital game as a neuropsychological test for postoperative cognitive dysfunction

Braz J Anesthesiol. 2022 Jan-Feb;72(1):7-12. doi: 10.1016/j.bjane.2021.06.025. Epub 2021 Jul 29.

Abstract

Objective: Postoperative cognitive dysfunction may result from worsening in a condition of previous impairment. It causes greater difficulty in recovery, longer hospital stays, and consequent delay in returning to work activities. Digital games have a potential neuromodulatory and rehabilitation effect. In this study, a digital game was used as a neuropsychological test to assess postoperative cognitive dysfunction, with preoperative patient performance as control.

Methods: It was a non-controlled study, with patients selected among candidates for elective non-cardiac surgery, evaluated in the pre- and postoperative periods. The digital game used has six phases developed to evaluate selective attention, alternating attention, visuoperception, inhibitory control, short-term memory, and long-term memory. The digital game takes about 25 minutes. Scores are the sum of correct answers in each cognitive domain. Statistical analysis compared these cognitive functions pre- and post-surgery using a generalized linear mixed model (ANCOVA).

Results: Sixty patients were evaluated, 40% male and 60% female, with a mean age of 52.7 ± 13.5 years. Except for visuoperception, a reduction in post-surgery scores was found in all phases of the digital game.

Conclusion: The digital game was able to detect decline in several cognitive functions postoperatively. As its completion is faster than in conventional tests on paper, this digital game may be a potentially recommended tool for assessing patients, especially the elderly and in the early postoperative period.

Keywords: Anesthesia; Cognitive dysfunction; Computers; Diagnostic self evaluation; Postoperative period.

MeSH terms

  • Adult
  • Aged
  • Cognition
  • Female
  • Humans
  • Male
  • Memory, Short-Term
  • Middle Aged
  • Neuropsychological Tests
  • Postoperative Cognitive Complications*