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Promoting brain health in older surgical patients: A pre-post evaluation of an educational module
Melanie Li1,2, Yasmin Alhamdah1,2,3, Ellene Yan2,4,3
1Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 3K3, Canada.
Background:
Older surgical patients are at a high risk for perioperative neurocognitive disorders, such as postoperative delirium (POD), yet awareness and engagement in brain health are low. The preoperative period represents a key opportunity to improve knowledge and preparedness through targeted education. This study evaluates the impact of a brief educational module on older adults' knowledge of brain health and POD, as well as its acceptability and perceived usefulness in the preoperative setting.
Methods:
A multicentre prospective pre-post interventional study was conducted in pre-admission clinics in Toronto, Canada. Adults ≥ 60 years old undergoing non-cardiac surgery completed a 20-item true/false questionnaire on brain health, cognitive impairment, and POD before and after a brief educational module. The primary outcome was the change in knowledge score, evaluated using the Wilcoxon signed-rank test. Secondary outcomes included participant satisfaction (5-point Likert scales) and a thematic analysis of open-ended feedback.
Results:
A total of 141 participants were included. Median knowledge scores improved significantly from 17 (15-18, interquartile range) to 19 (18-20) (p < 0.001; Cohen's d=0.79). Overall, 73% of participants demonstrated improvement, and 57.4% achieved a clinically meaningful gain of at least 1.2 points- equivalent to answering one additional answer correctly. Regression analysis confirmed the educational module as the only significant predictor of improvement. Gains in knowledge were greatest in delirium recognition, prevention, and risk factors. Satisfaction was high, with > 90% of patients finding the module to be helpful, understandable, and relevant. Qualitative feedback identified key themes including healthy lifestyle strategies, promotion of brain health, and delirium awareness.
Conclusions:
A brief educational module significantly increased older surgical patients' knowledge about brain health and POD. High satisfaction supports its potential role as part of routine perioperative care. These findings support the integration of a targeted module into preoperative care as a simple and acceptable strategy to promote patient knowledge, engagement, and readiness for surgery.
