Reliability In Neurocognitive Telemedicine Screening (RING)

NCT07760545 | Recruiting

• 1 other identifier: H22-03455
• Study Type: observational
• Target: 300
• Locations: 1 country
• Sites: 1

Brief Summary

Perioperative neurocognitive disorders are common after surgery and pre-existing cognitive impairment is an important risk factor. Current guidelines recommend identifying cognitive impairment before surgery; however, screening remains inconsistent, particularly when preoperative assessments are performed remotely. This prospective observational diagnostic validation study aims to determine whether a modified Mini-Cog cognitive screening tool administered by telephone can reliably identify cognitive impairment in patients aged 65 years and older undergoing preoperative assessment. Telephone-based modified Mini-Cog results will be compared with standard in-person Mini-Cog assessments to evaluate agreement and feasibility. This study may improve access to preoperative cognitive screening and support optimization of surgical care for older adults.

Conditions

Cognitive Impairment; Preoperative Cognitive Impairment; Perioperative Neurocognitive Disorders; Neurocognitive Function; Cognitive Screening

Keywords

Perioperative neurocognitive disorders; Cognitive impairment; Preoperative cognitive screening; Cognitive assessment; Mini-Cog; Modified Mini-Cog; Telephone-based cognitive screening; Telemedicine

Outcome Measures

Primary Outcomes (1)

• Concordance between telephone-administered modified Mini-Cog and standard in-person Mini-Cog assessment

  Agreement between modified Mini-Cog scores obtained by telephone and standard in-person Mini-Cog scores in identifying cognitive impairment using the established Mini-Cog cutoff score.

  Within 1-2 weeks of telephone assessment

Secondary Outcomes (3)

• Sensitivity and specificity of telephone modified Mini-Cog

  Within 1-2 weeks of telephone assessment

• Completion time of modified Mini-Cog assessment

  During each assessment

• Feasibility of telephone-based cognitive screening

  During telephone assessment

Interventions

Modified Mini-Cog Telephone Assessment DIAGNOSTIC_TEST

A modified Mini-Cog cognitive screening assessment administered by telephone to evaluate its reliability and concordance with standard in-person Mini-Cog assessment in older adults undergoing preoperative assessment.

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

This study will include adults aged 65 years and older who are scheduled for elective surgery and undergoing preoperative anesthetic assessment at Vancouver General Hospital or University of British Columbia Hospital. Participants will be recruited from the Pre-Admission Clinic referral list and will complete a modified Mini-Cog cognitive screening assessment by telephone followed by a standard in-person Mini-Cog assessment during their preoperative visit. The study population represents older adults undergoing surgical evaluation who do not have a known diagnosis of cognitive impairment.

You may qualify if:

• Patients with age \>65 at time of listing for pre-operative assessment.
• Patients with a conversational understanding of English language.
• Patients scheduled for in-person consult with an anaesthesiologist.
• Patients awaiting surgery at Vancouver General Hospital or University of British Columbia Hospital.

You may not qualify if:

• \. Patients with known cognitive impairment.

Sponsors & Collaborators

• University of British Columbia: lead
• Vancouver General Hospital: collaborator

Study Sites (1)

Vancouver General Hospital

Vancouver, British Columbia, BC V5Z 1M9, Canada

RECRUITING

Related Publications (13)

• R Core Team (2022). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/.

  BACKGROUND

• Rotondi MA (2018). _kappaSize: Sample Size Estimation Functions for Studies of Interobserver Agreement_. R package version 1.2, <https://CRAN.R-project.org/package=kappaSize>.

  BACKGROUND

• Graham JE, Rockwood K, Beattie BL, Eastwood R, Gauthier S, Tuokko H, McDowell I. Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet. 1997 Jun 21;349(9068):1793-6. doi: 10.1016/S0140-6736(97)01007-6.

  PMID: 9269213 BACKGROUND

• Donner A, Rotondi MA. Sample size requirements for interval estimation of the kappa statistic for interobserver agreement studies with a binary outcome and multiple raters. Int J Biostat. 2010;6(1):Article 31. doi: 10.2202/1557-4679.1275.

  PMID: 21969984 BACKGROUND

• Rezaei M, Rashedi V, Lotfi G, Shirinbayan P, Foroughan M. Psychometric Properties of the Persian Adaptation of Mini-Cog Test in Iranian Older Adults. Int J Aging Hum Dev. 2018 Apr;86(3):266-280. doi: 10.1177/0091415017724547. Epub 2017 Aug 31.

  PMID: 28859488 BACKGROUND

• Tiwary N, Treggiari MM, Yanez ND, Kirsch JR, Tekkali P, Taylor CC, Schenning KJ. Agreement Between the Mini-Cog in the Preoperative Clinic and on the Day of Surgery and Association With Postanesthesia Care Unit Delirium: A Cohort Study of Cognitive Screening in Older Adults. Anesth Analg. 2021 Apr 1;132(4):1112-1119. doi: 10.1213/ANE.0000000000005197.

  PMID: 33002933 BACKGROUND

• Adhikari SP, Dev R, Borson S. Modifying the Mini-Cog to Screen for Cognitive Impairment in Nonliterate Individuals. Int J Alzheimers Dis. 2021 Aug 16;2021:5510093. doi: 10.1155/2021/5510093. eCollection 2021.

  PMID: 34447592 BACKGROUND

• Wong DT, Kamming D, Salenieks ME, Go K, Kohm C, Chung F. Preadmission anesthesia consultation using telemedicine technology: a pilot study. Anesthesiology. 2004 Jun;100(6):1605-7. doi: 10.1097/00000542-200406000-00038. No abstract available.

  PMID: 15166585 BACKGROUND

• Culley DJ, Flaherty D, Fahey MC, Rudolph JL, Javedan H, Huang CC, Wright J, Bader AM, Hyman BT, Blacker D, Crosby G. Poor Performance on a Preoperative Cognitive Screening Test Predicts Postoperative Complications in Older Orthopedic Surgical Patients. Anesthesiology. 2017 Nov;127(5):765-774. doi: 10.1097/ALN.0000000000001859.

  PMID: 28891828 BACKGROUND

• Decker J, Kaloostian CL, Gurvich T, Nguyen P, Widjaja W, Cardona H, Pagan V, Motamed A, Peden CJ. Beyond Cognitive Screening: Establishing an Interprofessional Perioperative Brain Health Initiative. J Am Geriatr Soc. 2020 Oct;68(10):2359-2364. doi: 10.1111/jgs.16720. Epub 2020 Aug 3.

  PMID: 32748487 BACKGROUND

• Long LS, Shapiro WA, Leung JM. A brief review of practical preoperative cognitive screening tools. Can J Anaesth. 2012 Aug;59(8):798-804. doi: 10.1007/s12630-012-9737-1. Epub 2012 May 26.

  PMID: 22638676 BACKGROUND

• Mohanty S, Rosenthal RA, Russell MM, Neuman MD, Ko CY, Esnaola NF. Optimal Perioperative Management of the Geriatric Patient: A Best Practices Guideline from the American College of Surgeons NSQIP and the American Geriatrics Society. J Am Coll Surg. 2016 May;222(5):930-47. doi: 10.1016/j.jamcollsurg.2015.12.026. Epub 2016 Jan 4. No abstract available.

  PMID: 27049783 BACKGROUND

• Dworkin A, Lee DS, An AR, Goodlin SJ. A Simple Tool to Predict Development of Delirium After Elective Surgery. J Am Geriatr Soc. 2016 Nov;64(11):e149-e153. doi: 10.1111/jgs.14428. Epub 2016 Sep 21.

  PMID: 27650453 BACKGROUND

MeSH Terms

Conditions

Cognitive Dysfunction

Condition Hierarchy (Ancestors)

Cognition Disorders; Neurocognitive Disorders; Mental Disorders

Study Officials

• Stewart Brown, MD

  University of British Columbia

  STUDY DIRECTOR

Central Study Contacts

Donald Young, MD

CONTACT

800-604-875-4304; donald.young@vch.ca

Shirley Lim, BSN, BS-HRIM

CONTACT

604-875-4111; shirley.lim@vch.ca

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: August 7, 2026
• First Posted: August 12, 2026
• Study Start: May 2, 2023
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): January 30, 2027
• Last Updated: August 12, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)