Preoperative Cognitive Optimization and Postoperative Cognitive Outcomes: A Narrative Review.

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Clinical Interventions in Aging Pub Date : 2025-03-27 eCollection Date: 2025-01-01 DOI:10.2147/CIA.S505388

Yumiko Ishizawa

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引用次数: 0

Abstract

Background: Perioperative neurocognitive disorder (PND) is a growing concern and affects millions of older adult surgical patients each year in the United States. However, the effective prevention of PND has yet to be established. Recently, preoperative brain exercise has been suggested to decrease postoperative delirium incidence in older patients. This review aims to interpret existing preoperative cognitive optimization research, determine if the research supports preoperative cognitive optimization, and identify gaps in the knowledge of the older surgical population.

Methods: A literature search was performed in Pub Med (1995-2024) using the keywords (Older Surgical Patients, Presurgical Assessment, Cognitive Optimization, Neurocognitive Disorder, Postoperative Cognitive Impairment, Postoperative Delirium, Dementia, Frailty Syndrome, Prehabilitation, and Brain Plasticity). The type of literature included clinical trials, case series, cohort studies, and reviews. Among these articles, I included the one in which full text is available in Pub Med and is identified that specifically investigates cognitive function in older adults.

Results and conclusion: Evidence of the effect of preoperative cognitive optimization on postoperative cognitive functions in older adult surgical patients is still limited. Postoperative delirium was reduced by preoperative cognitive training. A limited number of clinical studies suggest the beneficial effect of preoperative cognitive training, but others show no effects. Further studies are needed on the cognitive training dosage, duration, and platform type. Studies are also required in presurgical patients with preexisting cognitive impairment or dementia.

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背景：围手术期神经认知障碍（PND）日益受到关注，每年影响着美国数百万老年手术患者。然而，有效预防 PND 的方法尚未确立。最近，有人提出术前脑部锻炼可以降低老年患者术后谵妄的发生率。本综述旨在解读现有的术前认知优化研究，确定研究是否支持术前认知优化，并找出老年手术人群在这方面的知识空白：使用关键词（老年手术患者、术前评估、认知优化、神经认知障碍、术后认知障碍、术后谵妄、痴呆、虚弱综合征、术前康复和脑可塑性）在 Pub Med（1995-2024 年）上进行了文献检索。文献类型包括临床试验、病例系列、队列研究和综述。在这些文章中，我收录了可在 Pub Med 上查阅全文并能确定是专门研究老年人认知功能的文章：术前认知优化对老年手术患者术后认知功能影响的证据仍然有限。术前认知训练可减少术后谵妄。少数临床研究表明术前认知训练有益处，但其他研究则显示没有效果。关于认知训练的剂量、持续时间和平台类型还需要进一步研究。还需要对术前已有认知障碍或痴呆症的患者进行研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.80

自引率

2.80%

发文量

193

审稿时长

6-12 weeks

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.