Clinical Research Directory

Inclusion Criteria: 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 Exclusion Criteria: PATIENT PARTICIPANTS: * Emergency or urgent surgeries * Reoperation after prior total hip, knee, or complex spine surgery * 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: * Unable or unwilling to provide written consent * 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 * 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