Adding ‘Formal Years of Education’ to Patients' Preoperative Screening

There is ample rationale for institutions and clinicians embracing the concept of perioperative brain health to incorporate years of formal education as a routine preoperative screening question. Although not perfect, years of formal education is a good surrogate measure of premorbid intellect and cognitive reserve, based on a hypothesis that education may be protective against later cognitive decline, including protection from neurological insult and neurodegeneration (J Consult Clin Psych 1984;52:885-7; Neuropsychology 1996;7:273-95; Neuropsychology 2015;29:649-57; Clin Neuropsychol 2021;36:1291-5; Handb Clin Neurol 2019;167:181-90). Years of formal education is a predictor of postoperative cognitive decline, delirium, and postoperative emergency department visits (Anesthesiology 2008;108:18-30; Lancet 1998;351:857-61; Ann Thorac Surg 1995;59:1326-30; Anesth Analg 2021;132:846-55; J Laparoendosc Adv Surg Tech A 2018;28:1100-4). Years of education is associated with health literacy and comprehension of perioperative patient materials (Arthrosc Sports Med Rehabil 2022;4:e1575-9). Acquiring...