Preoperative Cognitive Optimization and Postoperative Cognitive Outcomes: A Narrative Review
Yumiko Ishizawa Department of Anesthesia, Critical Care & Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USACorrespondence: Yumiko Ishizawa, Department of Anesthesia, Critical Care & Pain Medicine, Massachusetts General Hospital, 55 Fruit Street Gray Jacks...
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Dove Medical Press
2025-03-01
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| author | Ishizawa Y |
| author_facet | Ishizawa Y |
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| description | Yumiko Ishizawa Department of Anesthesia, Critical Care & Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USACorrespondence: Yumiko Ishizawa, Department of Anesthesia, Critical Care & Pain Medicine, Massachusetts General Hospital, 55 Fruit Street Gray Jackson 444, Boston, MA, 02114, USA, Email yishizawa@mgh.harvard.eduBackground: 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.Keywords: perioperative neurocognitive disorder, postoperative cognitive impairment, postoperative delirium, cognitive frailty, cognitive optimization |
| format | Article |
| id | doaj-art-a24423ac00d841b09da7e9082a3aea3f |
| institution | DOAJ |
| issn | 1178-1998 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Interventions in Aging |
| spelling | doaj-art-a24423ac00d841b09da7e9082a3aea3f2025-08-20T02:54:12ZengDove Medical PressClinical Interventions in Aging1178-19982025-03-01Volume 20395402101540Preoperative Cognitive Optimization and Postoperative Cognitive Outcomes: A Narrative ReviewIshizawa YYumiko Ishizawa Department of Anesthesia, Critical Care & Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USACorrespondence: Yumiko Ishizawa, Department of Anesthesia, Critical Care & Pain Medicine, Massachusetts General Hospital, 55 Fruit Street Gray Jackson 444, Boston, MA, 02114, USA, Email yishizawa@mgh.harvard.eduBackground: 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.Keywords: perioperative neurocognitive disorder, postoperative cognitive impairment, postoperative delirium, cognitive frailty, cognitive optimizationhttps://www.dovepress.com/preoperative-cognitive-optimization-and-postoperative-cognitive-outcom-peer-reviewed-fulltext-article-CIAperioperative neurocognitive disorderpostoperative cognitive impairmentpostoperative deliriumcognitive frailtycognitive optimization |
| spellingShingle | Ishizawa Y Preoperative Cognitive Optimization and Postoperative Cognitive Outcomes: A Narrative Review Clinical Interventions in Aging perioperative neurocognitive disorder postoperative cognitive impairment postoperative delirium cognitive frailty cognitive optimization |
| title | Preoperative Cognitive Optimization and Postoperative Cognitive Outcomes: A Narrative Review |
| title_full | Preoperative Cognitive Optimization and Postoperative Cognitive Outcomes: A Narrative Review |
| title_fullStr | Preoperative Cognitive Optimization and Postoperative Cognitive Outcomes: A Narrative Review |
| title_full_unstemmed | Preoperative Cognitive Optimization and Postoperative Cognitive Outcomes: A Narrative Review |
| title_short | Preoperative Cognitive Optimization and Postoperative Cognitive Outcomes: A Narrative Review |
| title_sort | preoperative cognitive optimization and postoperative cognitive outcomes a narrative review |
| topic | perioperative neurocognitive disorder postoperative cognitive impairment postoperative delirium cognitive frailty cognitive optimization |
| url | https://www.dovepress.com/preoperative-cognitive-optimization-and-postoperative-cognitive-outcom-peer-reviewed-fulltext-article-CIA |
| work_keys_str_mv | AT ishizaway preoperativecognitiveoptimizationandpostoperativecognitiveoutcomesanarrativereview |