Association between preoperative cognitive impairment and perioperative neurocognitive disorders within 30 days after surgery in elderly patients: a secondary exploratory retrospective analysis

Background Preoperative cognitive impairment (PCI) is a recognized risk factor for postoperative cognitive dysfunction, but its association with the broader syndrome of perioperative neurocognitive disorders (PND) within 30 days after surgery requires further investigation. This study aimed to evaluate the association between preoperative cognitive performance, assessed by the Montreal Cognitive Assessment (MoCA), and the risk of PND in elderly patients. Methods This secondary exploratory retrospective analysis based on a completed prospective randomized controlled trial (RCT) cohort included 236 patients aged ≥65 years undergoing non-cardiac surgery under general anesthesia. Preoperative cognitive performance was evaluated using the MoCA, with a score Results The overall incidence of PND was 40.7%. Patients with PCI (n = 81) had a significantly higher incidence of PND compared to those without PCI (74.1% vs. 23.2%, p Conclusion Preoperative cognitive impairment, assessed by the MoCA, is an independent risk factor for PND within 30 days after surgery in elderly patients. Preoperative MoCA screening may help identify high-risk patients for targeted interventions.