Postsurgical Pain and Opioid Use in Older Adults: Effects of Mild Cognitive Impairment

Korábbi kezelés

• Reoperation after prior total hip, knee, or complex spine surgery

Más betegség

• Current or past dementia diagnosis
• History of cerebrovascular disease or stroke
• Diagnosis of postoperative or post-intensive care neurocognitive disorder within the 12 months
  • CAREGIVER PARTICIPANTS:
• Evidence of impaired decisional capacity (e.g., known dementia, acute intoxication, or acute medical or psychiatric condition)-disqualifying particularly for a caregiver serving as surrogate/LAR

Egyéb

• PATIENT PARTICIPANTS:
• Emergency or urgent surgeries
• Unable or unwilling to provide written consent
• Sensory, motor, cognitive, or language limitation precluding reliable self-completion of questionnaires
• Paid/professional caregiver serving in a formal capacity (e.g., hired aide or private-duty nurse), as the study targets informal caregiving
• Declines participation

• PATIENT PARTICIPANTS:
• Aged 65 years or older
• Ability to provide informed consent
• English literacy sufficient to complete study measures
• No daily opioid use in the prior 3 months
• Residence within a 1-hour drive of Nashville
• Deemed healthy enough for quantitative sensory testing (QST) procedures by surgical Co-Investigators
• Undergoing elective surgical procedures including tier 2 or 3 procedures (e.g., posterior cervical fusion, thoracic/lumbar fusion >= 3 levels)
  • CAREGIVER PARTICIPANTS:
• Age >= 18 years at the time of consent
• Identified as the patient's spouse/partner, adult family member, or other unpaid informal caregiver-and, for a patient scoring <= 14.5 on the University of California San Diego Brief Assessment of Capacity to Consent (UBACC), the designated surrogate/legally authorized representative (LAR) under the applicable institutional and state hierarchy
• In regular contact with the patient (in person, by phone, or by video) across the 6-month follow-up period, sufficient to observe the patient's home opioid use
• Able to read and respond to study materials in English
• Able and willing to provide written consent-for their own participation and/or on the patient's behalf as surrogate/LAR
• Passes the pre-consent caregiver cognitive/capacity screen