The goal of this observational study is to explore early cognitive changes in patients aged 70 years or older undergoing same-day discharge after hip or knee replacement surgery. The main question it aims to answer is:
Does patients experience cognitive changes in cognitive test performance from before surgery to the first day after surgery?
Participants will:
* Complete a cognitive test battery virtually about 14 days before surgery, and on the first and seventh day after their operation. * Record pain levels and pain medicine use during the first week after surgery
Unilateral elective primary Total Hip Arthroplasty, Total Knee Arthroplasty, or Unicompartmental Knee
Native Danish speaker
Spinal anesthesia
Inability or unwillingness to provide informed consent
Inability to comply with virtual study procedures or follow-up sessions, including because of visual or hearing impairment
Known dementia or other diagnosed cognitive disorders or Brief Assessment of Impaired Cognition (BASIC)≤20
Parkinson's disease or other neurological conditions causing functional impairment
Patients scheduled for hip or knee arthroplasty at Svendborg hospital, Denmark.
Cohort
Prospective
Not listed
Change in Symbol Digit Modalities Test (SDMT) score from baseline to postoperative day 1.
The SDMT is a validated neuropsychological tool that measures processing speed, attention, and visual scanning. The SDMT will be administered virtually as an oral 90-second test. The primary metric will be the SDMT score, defined as the number of correct digit substitutions completed within 90 seconds
Change in Symbol Digit Modalities Test (SDMT) score from baseline to postoperative day 7.
The SDMT is a validated neuropsychological tool that measures processing speed, attention, and visual scanning. The SDMT will be administered virtually as an oral 90-second test. The primary metric will be the SDMT score, defined as the number of correct digit substitutions completed within 90 seconds
Change in Stroop Color-Word Test score from baseline to postoperative day 1.
The Stroop Color-Word Test is a validated measure of selective attention and susceptibility to interference. The primary metrics will be completion time (seconds) and number of errors recorded for each session.
Change in Stroop Color-Word Test score from baseline to postoperative day 7.
The Stroop Color-Word Test is a validated measure of selective attention and susceptibility to interference. The primary metrics will be completion time (seconds) and number of errors recorded for each session.
Change in Verbal fluency assessment score from baseline to postoperative day 1.
Verbal fluency assessment is a validated test which assesses executive function, semantic memory, and language. In our test a semantic (animal naming) and a phonemic (letter S) fluency task were used, each administered for 60 seconds. Number of correct responses for each task will be registered.
Cumulative In-hospital postoperative morphine consumption
Measured in milligrams
Cumulative postoperative morphine consumption
Measured in milligrams.
Postoperative pain intensity during rest once a day.
Patients will record pain intensity using an 11-point numeric rating scale (NRS, 0-10) in a pain diary.
Postoperative pain intensity during activity once a day
Patients will record pain intensity using an 11-point numeric rating scale (NRS, 0-10) in a pain diary. Pain will be assessed defined as a standardized 5-m walk test.
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