• Jason Tran, Tristen Nimojan, Aparna Saripella, David F Tang-Wai, Nina Butris, Paras Kapoor, Linor Berezin, Marina Englesakis, and Frances Chung.
• Department of Medicine, University of Ottawa, Ottawa, Canada.
• J Clin Anesth. 2022 Jun 1; 78: 110682.

ImportanceMild cognitive impairment (MCI) is a high-risk precursor to dementia, post-operative delirium, and prolonged hospitalization. There is a need for preoperative rapid cognitive screening tools.Study ObjectiveTo evaluate the predictive parameters of rapid MCI screening tools in different clinical settings for preoperative application.DesignSystematic review and meta-analyses searching Medline, and other databases from inception to May 26, 2021. The Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines were followed for data curation and quality assessment. Title and abstract screening were conducted independently via Rayyan. Data was curated through a random-effects model and statistical analysis used R-software.SettingCommunity, memory clinic, emergency, long-term care, and in-patient settings. There were no studies in the preoperative setting.PatientsTwenty-three studies with 9973 patients (≥ 60 years old) undergoing rapid MCI screening.InterventionRapid (≤ 5 min) MCI screening tools.MeasurementsPooled predictive parameters (sensitivity, specificity) of screening tests.Main ResultsEighteen screening tools, compared to neuropsychological tests, were identified. The overall prevalence of MCI among the Rapid Cognitive Screen (RCS), Six-item Screener (SIS), Mini-Cog, and Clock Drawing Test (CDT) studies were 24.6%, 28.3%, 40.9%, and 20.7%, respectively. RCS has 82% sensitivity and 79% specificity in detecting MCI. SIS has 61% sensitivity and 89% specificity. Mini-Cog has 52% sensitivity and 80% specificity. CDT has 56% sensitivity and 59% specificity. Seven other index tools had high sensitivities of 97%-82% and specificities of 90%-73% but were studied only once.ConclusionNo rapid screening tools had been validated in the surgical population. In other populations, RCS may be a promising screening tool for MCI with stronger sensitivity and specificity than Mini-Cog, SIS, and CDT. CDT alone is ineffective for MCI detection. Further validation in the preoperative setting is required to determine the efficacy of these screening tools.Copyright © 2022 Elsevier Inc. All rights reserved.

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