Cognitive Impairment, Frailty, Geriatric Oncology, Gynecologic Cancer
Conditions
Keywords
Cognitive Function, Frailty, MoCA, CFS, Decision Satisfaction, Postoperative Recovery, Geriatric Patients, Gynecologic Surgery, Patient-Reported Outcomes
Brief summary
This prospective observational study aims to evaluate the association between preoperative cognitive function, measured by the Montreal Cognitive Assessment (MoCA), and physical frailty, assessed using the Clinical Frailty Scale (CFS), with postoperative decision satisfaction and adaptation in geriatric patients undergoing gynecologic cancer surgery. Approximately 60 to 70 female patients aged 65 years or older will be enrolled. Participants will complete preoperative assessments of cognitive status and frailty. Postoperative outcomes including decision satisfaction, medication adherence, mobilization, respiratory exercise compliance, and return to functional baseline will be evaluated. The study is conducted at İzmir City Hospital and is designed to generate preliminary data to inform larger-scale research.
Detailed description
The study is designed as a prospective observational investigation involving geriatric female patients diagnosed with gynecologic cancers, including endometrial, ovarian, cervical, and vulvar malignancies. All participants are scheduled for elective surgical procedures at İzmir City Hospital. The primary objective is to explore the relationship between preoperative cognitive status, assessed by the Montreal Cognitive Assessment (MoCA), and physical frailty, assessed by the Clinical Frailty Scale (CFS), with postoperative decision satisfaction and multidimensional adaptation. Decision satisfaction will be measured using the Decision Regret Scale (DRS) within the first postoperative week. Postoperative adaptation will be evaluated through a composite score that includes early mobilization, adherence to respiratory exercises (such as incentive spirometry), medication adherence, attendance at follow-up appointments, and return to baseline functional capacity, assessed at postoperative day 30. Approximately 60 to 70 participants will be enrolled. Data will be analyzed using descriptive statistics, correlation analysis, and multivariable regression to identify the predictive value of cognitive and frailty assessments on postoperative outcomes. The findings are expected to contribute to the development of personalized perioperative care strategies for older adults with gynecologic cancers.
Interventions
OTHERNo Intervention - Observational Assessment
No intervention is applied. Preoperative cognitive status (MoCA) and physical frailty (CFS) are assessed as part of observational data collection. Postoperative follow-up includes decision satisfaction and adherence evaluations.
Sponsors
Izmir City Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Female patients aged 65 years or older * Diagnosed with a gynecologic malignancy (endometrial, ovarian, cervical, or vulvar cancer) * Scheduled for elective surgery with curative or staging intent * Ability to provide informed consent * Ability to complete preoperative cognitive (MoCA) and frailty (CFS) assessments
Exclusion criteria
* Diagnosis of severe dementia or MoCA score \<10 * Undergoing emergency surgery * Patients under exclusive palliative care * Non-Turkish speaking or inability to comprehend study assessments * Presence of severe psychiatric conditions interfering with cognitive assessment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Decision Satisfaction Score | From the day of surgery to postoperative day 15. | Decision satisfaction will be assessed using the Decision Regret Scale (DRS) on postoperative day 15. The scale measures the patient's satisfaction with the surgical decision-making process, with higher scores indicating greater regret. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Preoperative Cognitive Function (MoCA) | Up to 1 day before surgery | Cognitive function will be evaluated preoperatively using the Montreal Cognitive Assessment (MoCA), which assesses multiple cognitive domains. Lower scores indicate worse cognitive performance. |
| Preoperative Physical Frailty (CFS) | Up to 1 day before surgery | Physical frailty will be assessed preoperatively using the Clinical Frailty Scale (CFS), with higher scores indicating greater frailty. |
| Postoperative Adaptation Score | From the day of surgery to 30 days after surgery | A composite adaptation score will be assessed to evaluate postoperative recovery and behavioral adaptation. This score includes parameters such as early postoperative mobilization (e.g., time to ambulation), respiratory exercises compliance (e.g., frequency of incentive spirometry use), medication adherence, attendance to scheduled follow-ups, and return to baseline functional status. Higher scores indicate better postoperative adaptation. |
| Length of Hospital Stay | From date of surgery until hospital discharge, assessed up to 14 days | The number of days from the date of surgery to hospital discharge will be recorded as the length of hospital stay. |
| 30-Day Postoperative Complications | Within 30 days after surgery | Postoperative complications occurring within 30 days of surgery will be recorded and classified according to the Clavien-Dindo classification system. |
Countries
Turkey (Türkiye)
Outcome results
None listed