Mika M. Rockholt ^1,2 Rachel R. Wu ^1,2 Elaine Zhu ^1,2 Raven Perez ^1,2 Hamleini Martinez ^1,2 Jessica Hui ^1,2 Ekow B. Commeh ^1,2 Romario Denoon ^1,2 Gabrielle Bruno ^1,3 Braden V. Saba ^1,3 Daniel Waren ^1,3 Courtney O'brien ^1,4 Vinay K. Aggarwal ^1,3 Joshua C. Rozell ^1,3 David Furgiuele ^1,2 William Macaulay ^1,3 Ran Schwarzkopf ^1,3 Evan T. Schulze ^1,5,6 Ricardo Osorio ^1,7 Lisa Doan ^1,2* Jing Wang ^1,2,8*

• ¹ Langone Medical Center, New York University, New York City, United States
• ² Department of Anesthesiology, Perioperative Care, and Pain Medicine, School of Medicine, New York University, New York, New York, United States
• ³ Department of Orthopedic Surgery, Grossman School of Medicine, New York University, New York City, New York, United States
• ⁴ Department of Psychiatry, Grossman School of Medicine, New York University, New York, United States
• ⁵ Department of Clinical Neuropsychology, Grossman School of Medicine, New York University, New York City, United States
• ⁶ Department of Neurology, Grossman School of Medicine, New York University, New York City, United States
• ⁷ Department of Psychiatry, Grossman School of Medicine, New York University, New York City, United States
• ⁸ Department of Neuroscience and Physiology, School of Medicine, New York University, New York, United States

Older adults undergoing surgery are at risk of postoperative neurocognitive disorders, prompting the need for preoperative cognitive screening in this population. Traditionally, cognitive screening has been conducted in-person using brief assessment tools such as the Montreal Cognitive Assessment (MoCA) or the Mini-Mental State Examination (MMSE). More comprehensive test batteries, such as the Uniform Data Set (UDS) Neuropsychological Battery, and its remote testing version, the Uniform Data Set version 3 tele-adapted test battery (UDS v3.0 T-cog), have been developed to assess cognitive decline in normal aging and disease conditions, but have not been applied in the perioperative setting.In this study, we assessed the feasibility of using this remote UDS v3.0 T-cog battery for preoperative cognitive assessment in older adults scheduled for lower extremity joint replacement surgery. Our results indicate that the UDS v3.0 T-cog achieves 99% completion rates and demonstrates high patient satisfaction. Further, we found 28% of subjects were cognitively impaired in this patient cohort. These findings suggest that the UDS v3.0 T-cog is a feasible tool for assessing cognitive function in the older adult perioperative population. To our knowledge, this is the first study to apply this comprehensive remote test battery in the preoperative setting.