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Related Experiment Video

Updated: May 16, 2025

Translational Brain Mapping at the University of Rochester Medical Center: Preserving the Mind Through Personalized Brain Mapping
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Preoperative Cognitive Optimization and Postoperative Cognitive Outcomes: A Narrative Review.

Yumiko Ishizawa1

  • 1Department of Anesthesia, Critical Care & Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Clinical Interventions in Aging
|April 1, 2025
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Summary

Preoperative cognitive training may reduce postoperative delirium in older surgical patients, but more research is needed. Studies show mixed results on effectiveness, highlighting a need for optimal training protocols.

Keywords:
cognitive frailtycognitive optimizationperioperative neurocognitive disorderpostoperative cognitive impairmentpostoperative delirium

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Area of Science:

  • Geriatric Medicine
  • Neuroscience
  • Surgical Patient Care

Background:

  • Perioperative neurocognitive disorder (PND) is a significant concern for millions of older adults undergoing surgery annually in the US.
  • Effective prevention strategies for PND remain elusive.
  • Preoperative cognitive interventions are being explored to mitigate postoperative delirium.

Purpose of the Study:

  • To review and interpret existing research on preoperative cognitive optimization in older surgical patients.
  • To assess the current evidence supporting cognitive optimization as a PND prevention strategy.
  • To identify knowledge gaps concerning older surgical populations and cognitive interventions.

Main Methods:

  • A comprehensive literature search was conducted in PubMed (1995-2024).
  • Keywords included 'Older Surgical Patients,' 'Cognitive Optimization,' 'Postoperative Delirium,' and 'Prehabilitation.'
  • Included studies were full-text articles investigating cognitive function in older adults, encompassing clinical trials, case series, cohort studies, and reviews.

Main Results:

  • Evidence for preoperative cognitive optimization's impact on postoperative cognitive function in older adults is currently limited.
  • Some studies indicate preoperative cognitive training can reduce postoperative delirium.
  • However, other studies show no significant effects, necessitating further investigation into training parameters.

Conclusions:

  • The efficacy of preoperative cognitive training for preventing PND requires further investigation, particularly regarding optimal dosage, duration, and delivery methods.
  • Research is needed to evaluate these interventions in presurgical patients with pre-existing cognitive impairment or dementia.
  • Further studies are crucial to establish effective cognitive optimization strategies for older surgical patients.