TY - JOUR
T1 - Cognition, literacy, and education in colonoscopy preparation for older adults
T2 - Highlights from two clinical case reports
AU - Joffe, Yonah
AU - Burt, Juliana S.
AU - Eversole, Kara
AU - Estores, David
AU - Libon, David J.
AU - Arias, Franchesca
AU - Seubert, Christoph N.
AU - Chapin, Benjamin A.
AU - Garvan, Cynthia Wilson
AU - Price, Catherine C.
N1 - Publisher Copyright:
© 2025
PY - 2025/12
Y1 - 2025/12
N2 - Introduction: Cognitive function, literacy, and education may affect adherence to colonoscopy bowel preparation and predict clinical outcomes. The two case studies presented include preoperative cognitive and educational information rarely captured for routine colonoscopies. Using a novel clinical service, we highlight the relationship between specific preoperative variables and failed colonoscopy bowel preparation. Case presentations: Case CR is a 69-year-old White non-Hispanic male who showed symptoms of amnestic mild cognitive impairment upon preoperative evaluation. CR's at-home bowel preparation was inadequate due to poor instruction adherence and ultimately led to an incomplete colonoscopy. Case JR is an 85-year-old Black non-Hispanic male with 4 years of education, 3rd grade reading level, and memory deficits. JR misunderstood the pre-procedure instructions, causing him to complete the bowel preparation on the wrong day. Subsequently, JR rescheduled the procedure several times, missed his preoperative evaluation for his rescheduled procedure, and ultimately never received his recommended colonoscopy. Conclusion: Unsuccessful colonoscopy procedures have significant consequences, including missed precancerous polyps and malignant lesions and inefficient allocation of medical and financial resources. Cases highlight the need for interdisciplinary colonoscopy procedure planning for older patients with high-risk neurocognitive and educational profiles.
AB - Introduction: Cognitive function, literacy, and education may affect adherence to colonoscopy bowel preparation and predict clinical outcomes. The two case studies presented include preoperative cognitive and educational information rarely captured for routine colonoscopies. Using a novel clinical service, we highlight the relationship between specific preoperative variables and failed colonoscopy bowel preparation. Case presentations: Case CR is a 69-year-old White non-Hispanic male who showed symptoms of amnestic mild cognitive impairment upon preoperative evaluation. CR's at-home bowel preparation was inadequate due to poor instruction adherence and ultimately led to an incomplete colonoscopy. Case JR is an 85-year-old Black non-Hispanic male with 4 years of education, 3rd grade reading level, and memory deficits. JR misunderstood the pre-procedure instructions, causing him to complete the bowel preparation on the wrong day. Subsequently, JR rescheduled the procedure several times, missed his preoperative evaluation for his rescheduled procedure, and ultimately never received his recommended colonoscopy. Conclusion: Unsuccessful colonoscopy procedures have significant consequences, including missed precancerous polyps and malignant lesions and inefficient allocation of medical and financial resources. Cases highlight the need for interdisciplinary colonoscopy procedure planning for older patients with high-risk neurocognitive and educational profiles.
UR - https://www.scopus.com/pages/publications/105018102886
UR - https://www.scopus.com/inward/citedby.url?scp=105018102886&partnerID=8YFLogxK
U2 - 10.1016/j.pcorm.2025.100566
DO - 10.1016/j.pcorm.2025.100566
M3 - Article
AN - SCOPUS:105018102886
SN - 2405-6030
VL - 41
JO - Perioperative Care and Operating Room Management
JF - Perioperative Care and Operating Room Management
M1 - 100566
ER -