51 * THE PREVALENCE OF COGNITIVE IMPAIRMENT MEASURED USING THE MONTREAL COGNITIVE ASSESSMENT METHOD (MOCA) IN AN OLDER ACUTE GENERAL SURGICAL POPULATION

Abstract

Introduction: Rates of all surgical procedures are increasing at a faster rate than the population is ageing. However, this encouraging statistic, necessitates a robust evidence base. The epidemiological evidence base in acute general surgery in the older person is sparse. This is the first assessment of the prevalence of cognitive impairment measured using the MoCA in this setting.Methods: In three sites in Wales, England and Scotland comprising rural and urban populations, we studied consecutive patients aged over 65 years. We considered any older person admitted to the acute general surgical unit. We did not include patients with orthopaedic, urological, neurosurgical or vascular conditions. We assessed them for baseline demographic data. They each underwent a MoCA assessment. Permission was granted for the use of the MoCA in the research setting. We did not assess delirium.Results: We collected data on 220 people, mean age 77 years (range 65–99), 156 (56.1%) were women. Of these 189 completed the MoCA test, Median score 21 (range 0–30). There were 33 (17.1%) MoCA scores in the normal range (> = 26). Increasing age (p < 0.001) but not sex (p = 0.34) predicted an abnormal MoCA.Of the 41 (18.6%) people who were unable to complete the MoCA assessment, 22 were known to have a diagnosis of dementia, 15 were too unwell and the remainder unable to complete the assessment to due pre-existing disability, most commonly poor vision.Conclusions: In a representative UK wide population, over 80% of people aged over 65 years admitted with an acute general surgical problem had cognitive impairment when assessed using the MoCA.