As an anesthesiologist at the Brigham and Women’s Hospital my clinical work focuses on the delivery quality care to patients presenting for complex neurosurgical procedures and to serve as a resource on the perioperative care of geriatric patients.
As Director of the Neurobehavioral Laboratory and a Co-Director of the Aging Neuroscience Lab, my research efforts have been directed toward studying the long-term effects of general anesthesia on the aging brain in rodents. In the course of this work we have demonstrated that general anesthesia can lead to persistent changes in the aged brain and this has become one of the hottest topics in anesthesiology. We have also noted that cognitive aging is a heterogeneous process that is not simply defined by age in both rodents and humans. Our work on these topics have been funded by: National Institutes of Health, Foundation for Anesthesia Education and Research, Harvard/Hartford Foundation, American Geriatrics Society and the Anesthesia Patient Safety Foundation. Most recently we have noted that over 20% of patients over the age of 65 presenting to our preadmission testing center for their preoperative evaluation have some evidence of impaired cognitive performance when screened using the Mini-Cog. This present proposal proposes to evaluate whether preoperative cognitive performance based on Mini-Cog screening can identify patients at risk for adverse surgical outcomes. Accordingly, these studies may be important for patient and physician decision-making and improved surgical outcomes in elderly patients after anesthesia and surgery.