Cognitive Prehabilitation: How Can We Counter Neurocognitive Frailty?

Fink, Adam; Humeidan, Michelle; Bentov, Itay

doi:10.1016/j.euf.2023.11.005

European Urology Focus

2024

DOI: 10.1016/j.euf.2023.11.005

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Cognitive Prehabilitation: How Can We Counter Neurocognitive Frailty?

Adam Fink,

Michelle Humeidan,

Itay Bentov

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2024

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Cited by 5 publications

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“…Given the prevalence of cognitive disorders in ICU survivors, prehabilitation programs increasingly incorporate cognitive exercises. These exercises, including game playing, memory and recall training, and problem-solving tasks, have demonstrated effectiveness in enhancing cognitive reserve [ 13 ].…”

mentioning

confidence: 99%

Expanding the scope of prehabilitation: reducing critical illness weakness across elective surgical patients scheduled for postoperative ICU care

Gao,

Jin

2024

Crit Care

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mentioning

confidence: 99%

Expanding the scope of prehabilitation: reducing critical illness weakness across elective surgical patients scheduled for postoperative ICU care

Gao,

Jin

2024

Crit Care

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Prehabilitation: A multidimensional adjunct to comprehensive personalized oncologic care. But, can we make it pragmatic?

Psutka

2024

European Urology Focus

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Current developments in prehabilitation in urologic oncology

Petersen,

Cavanaugh,

Psutka

2024

Current Opinion in Urology

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Purpose of review Prehabilitation describes interventions that are undertaken prior to a major surgical or medical intervention with the objective of improving functional capability with the goal of improving candidacy for therapy, bolstering one's ability to withstand treatment-associated toxicity, functional decline, and facilitating accelerated recovery. The objective of this review is to detail the key tenets of prehabilitation, synthesize contemporary advances in prehabilitation science within Urologic Oncology, and discuss key methodologic trial design considerations salient to future prehabilitation investigations. Recent findings Contemporary prehabilitation clinical trials have primarily evaluated unimodal interventions aiming to improve functional capacity across the domains of physical exercise, nutrition, and cognition with heightened interest in evaluating multimodal interventions addressing two or more domains. Recent investigations have have demonstrated variable improvements in strength, balance, physical function, and quality of life with preoperative exercise. Although presurgical immunonutrition showed promise in other fields, initial results in uro-oncology have not demonstrated reductions in complications nor improvements in early survival. Emerging data supports the potential of multimodal prehabilitation programs to offer more comprehensive benefits, improving functional outcomes, reducing length of stay, and supporting improved recovery. Summary To date, early prehabilitation studies in patients undergoing surgery for genitourinary malignancies have demonstrated variable ability to facilitate gains in functional capacity and perioperative outcomes. Key issues have arisen including the need to ensure that interventions are pragmatic, scalable, feasible, and acceptable in these populations that often also have a high prevalence of coincident multimorbidity, frailty, and mental health concerns that can increase risk of adverse outcomes after surgery. The integration of personalized prehabilitation strategies as extensions of perioperative enhanced recovery after surgery protocols, supportive care and survivorship paradigms offers of promise to further engage patients in their care, enhance patient resilience and outcomes, while reducing treatment burden in urologic oncology.

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Cognitive Prehabilitation: How Can We Counter Neurocognitive Frailty?

Cited by 5 publications

References 14 publications

Expanding the scope of prehabilitation: reducing critical illness weakness across elective surgical patients scheduled for postoperative ICU care

Expanding the scope of prehabilitation: reducing critical illness weakness across elective surgical patients scheduled for postoperative ICU care

Prehabilitation: A multidimensional adjunct to comprehensive personalized oncologic care. But, can we make it pragmatic?

Current developments in prehabilitation in urologic oncology

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