Short-term perioperative cognitive therapy combined with rehabilitation exercise reduces the incidence of neurocognitive disorder in elderly patients: a randomized controlled trial

Duan, Siyu; Liao, Yan; Tang, Yujie; Zhang, Bin; Peng, Mingchao; Tong, Jianbin; Ouyang, Wen; Yuan, Long

doi:10.23736/s0375-9393.21.15877-8

Cited by 8 publications

(9 citation statements)

References 38 publications

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“…At present, clinical prevention and treatment measures for POCD mainly include drug therapy, nondrug therapy, or a combination of both. Nondrug measures include adopting minimally invasive surgery, improving the effective perfusion of tissues and organs during surgery ( Borsook et al, 2010 ), strengthening postoperative analgesia ( Evered et al, 2021 ), controlling the depth of anesthesia ( O’Brien et al, 2017 ), and promoting physical exercise in the perioperative period ( Rengel et al, 2021 ; Duan et al, 2022 ). Drug methods include the use of dexmedetomidine ( Su et al, 2016 ), COX-2 inhibitors ( Margraf et al, 2020 ), statins ( Alam et al, 2018 ), and probiotics during the perioperative period ( Wang et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Nomogram to predict postoperative cognitive dysfunction in elderly patients undergoing gastrointestinal tumor resection

Huang

Chou

Tang

et al. 2022

Front. Aging Neurosci.

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ObjectiveTo establish a nomogram model for the prediction of postoperative cognitive dysfunction (POCD) in elderly patients undergoing gastrointestinal tumor resection.MethodsA total of 369 elderly patients scheduled for elective gastrointestinal tumor resection under general anesthesia were included. The cognitive function of each participant was assessed by the Mini-Mental State Examination (MMSE) 1 day before surgery and 7 days after surgery for the diagnosis of POCD. According to the results, patients were divided into a POCD group and a non-POCD group. The differences in hospitalization data and examination results between the two groups were compared. A logistic regression model was used to explore the risk factors for POCD in elderly patients undergoing gastrointestinal tumor resection, and a nomogram was then constructed based on these factors. The diagnostic performance of the nomogram was evaluated using the area under the receiver operating characteristic curve (AUROC) and a calibration plot. The clinical usefulness of the nomogram was estimated using decision curve analysis (DCA).ResultsAmong the 369 patients undergoing gastrointestinal tumor resection, 79 patients had POCD, with a positive rate of 21.4%. The nomogram model comprised the following variables: age, body mass index (BMI), history of cerebrovascular disease, preoperative white blood cell (WBC) count, preoperative hemoglobin (Hb) level, intra-operative blood loss, and operation time. The model showed good discrimination, with an area under the curve (AUC) of 0.710 (95% CI = 0.645–0.775), and good calibration (Hosmer–Lemeshow test, χ2 = 5.133, p = 0.274). Internal validation also maintained ideal discrimination and calibration. Decision curves indicated that when the threshold probability was above 0.1, the nomogram achieved more benefit than both the treat-all and treat-none policies.ConclusionThis scoring system is the first nomogram model developed for the prediction of POCD in elderly patients undergoing gastrointestinal tumor resection. It has good efficacy in the prediction of POCD risk and could provide an important reference for the prevention, management, and treatment of POCD.

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Section: Introductionmentioning

confidence: 99%

Nomogram to predict postoperative cognitive dysfunction in elderly patients undergoing gastrointestinal tumor resection

Huang

Chou

Tang

et al. 2022

Front. Aging Neurosci.

Self Cite

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“…Some studies have explored the effects of cognitive training combined with physical activity on POCD. Duan et al’s RCT of 86 elderly patients undergoing orthopedic surgery found that 30 min of reading-based cognitive training per day perioperative period combined with 40 min of physical activity per day postoperatively significantly reduced the incidence of POCD within 1 week postoperatively ( 66 ). Linying found that intellectual training combined with physical activity was effective in reducing the incidence of postoperative inflammatory factors and POCD in elderly patients undergoing fracture surgery ( 67 ).…”

Section: Resultsmentioning

confidence: 99%

The research progress of perioperative non-pharmacological interventions on postoperative cognitive dysfunction: a narrative review

Zhao,

Guo,

Zhou

et al. 2024

Front. Neurol.

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Postoperative cognitive dysfunction (POCD) is a common neurological complication in elderly patients after surgery and general anesthesia. The occurrence of POCD seriously affects the postoperative recovery of patients, and leads to prolonged hospital stay, reduced quality of life, increased medical costs, and even higher mortality. There is no definite and effective drug treatment for POCD. More evidence shows that perioperative non-pharmacological intervention can improve postoperative cognitive function and reduce the incidence of POCD. Therefore, our studies summarize the current non-pharmacological interventions of POCD from the aspects of cognitive training, physical activity, transcutaneous electrical acupoint stimulation, noninvasive brain stimulation, non-pharmacological sleep improvement, music therapy, environment, and multimodal combination Interventions, to provide more data for clinical application and research.

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“…None of the included studies were blinded to patients probably because CT requires patient cooperation and takes a long time. Blinding for outcome assessment was unclear in two studies ( 32 , 33 ). Clinical registrations for three studies were not found, and therefore, the risk was unclear for selective reporting ( 16 , 31 , 33 ).…”

Section: Resultsmentioning

confidence: 99%

“…Five studies assessed the incidence of POCD ( 14 , 16 , 17 , 24 , 32 ). Two studies ( 14 , 32 ) reported the incidence of POCD at 7 days postoperatively, and three studies ( 16 , 17 , 24 ) reported the incidence of POCD at hospital discharge.…”

Section: Resultsmentioning

confidence: 99%

Effects of perioperative cognitive function training on postoperative cognitive dysfunction and postoperative delirium: a systematic review and meta-analysis

et al. 2023

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BackgroundRandomized controlled trials (RCTs) have shown conflicting results regarding the effects of perioperative cognitive training (CT) on the incidence of postoperative cognitive dysfunction (POCD) and postoperative delirium (POD). We, therefore, performed a meta-analysis to assess the overall effects of studies on this topic.MethodsWe searched PubMed, Embase, the Cochrane Library, and Web of Science for all RCTs and cohort studies that investigated the effects of perioperative CT on the incidence of POCD and POD. Data extraction and quality assessment were conducted independently by two researchers.ResultsThis study included nine clinical trials with a total of 975 patients. The results showed that perioperative CT significantly reduced the incidence of POCD compared with the control group [risk ratio (RR) = 0.5, 95% CI (confidence interval): 0.28–0.89, P = 0.02]. Nevertheless, for the incidence of POD, the difference between the two groups was not statistically significant (RR = 0.64; 95% CI: 0.29–1.43, P = 0.28). In addition, the CT group had less postoperative decline in the cognitive function scores compared with the control group [mean differences (MD): 1.58, 95% CI: 0.57–2.59, P = 0.002]. In addition, there were no statistically differences in length of hospital stay between the two groups (MD: −0.18, 95% CI: −0.93–0.57, P = 0.64). Regarding CT adherence, the proportion of patients in the cognitive training group who completed the planned duration of CT was 10% (95% CI: 0.05–0.14, P = 0.258).ConclusionOur meta-analysis revealed that perioperative cognitive training is possibly an effective measure to reduce the incidence of POCD, but not for the incidence of POD.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022371306, identifier: CRD42022371306.

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Short-term perioperative cognitive therapy combined with rehabilitation exercise reduces the incidence of neurocognitive disorder in elderly patients: a randomized controlled trial

Cited by 8 publications

References 38 publications

Nomogram to predict postoperative cognitive dysfunction in elderly patients undergoing gastrointestinal tumor resection

Nomogram to predict postoperative cognitive dysfunction in elderly patients undergoing gastrointestinal tumor resection

The research progress of perioperative non-pharmacological interventions on postoperative cognitive dysfunction: a narrative review

Effects of perioperative cognitive function training on postoperative cognitive dysfunction and postoperative delirium: a systematic review and meta-analysis

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