Key result
Home-based cognitive training proves acceptable post-surgery but achieves only ~31% adherence.
Why the study?
Cognitive decline is common after cardiac surgery and associated with poor postoperative outcomes, motivating the evaluation of a home-based computerised cognitive training programme's feasibility and acceptability.
Home-based computerised cognitive training is acceptable to patients following cardiac surgery, but strategies to improve retention and adherence are needed before conducting a full-scale efficacy trial.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Heart surgery is a common procedure and patients can often experience problems with their cognitive health such as memory and attention. My project explored ways of improving that using brain training... This study was the first time anyone has looked at using this intervention in patients who've had heart surgery in the UK.”
Low adherence and retention preclude routine use of home-based cognitive training after cardiac surgery; leaves open efficacy pending targeted retention strategies and controlled trials.
Aims Cognitive decline is common after cardiac surgery and is associated with poor postoperative outcomes. The aim of this study was to evaluate the feasibility and acceptability of a home-based computerised cognitive training programme to improve POCD following cardiac surgery; this study was not designed to assess the efficacy of the intervention. Methods This single-arm, non-blinded, feasibility and acceptability study included patients ≥18 years undergoing first-time elective cardiac surgery using standard extracorporeal circulation. Participants were required to complete an eight-week computerised cognitive training (CCT) programme (20 minutes/day; five days/week), commencing one week after surgery. The Montreal Cognitive Assessment (MoCA) was administered preoperatively and after programme completion. Feasibility outcomes included recruitment and retention rates and programme adherence. Acceptability was assessed by the Theoretical Framework of Acceptability Questionnaire (TFA-Q). Results Twenty-nine participants were recruited: 7 (24%) were female and 20 (69%) were White British. Study recruitment was deemed to be feasible (61% of eligible patients) and the CCT was acceptable to 94% of participants who completed the TFA-Q (n=16), noting that this does not reflect the full recruited cohort. Intervention adherence (n=9, 31%) and study retention (n=17, 59%) were limited. Conclusions The findings of this feasibility study suggest that home-based CCT is deliverable and acceptable to patients following cardiac surgery, though strategies to improve retention and adherence will need to be strengthened before progression to an efficacy study.
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Gibson) et al. (2026) studied first-time elective cardiac surgery (n=29). Home-based computerised cognitive training (CCT) was evaluated on Feasibility (recruitment, retention, adherence) and acceptability. Home-based computerised cognitive training was acceptable to 94% of completers and recruitment was feasible, but intervention adherence (31%) and study retention (59%) were limited.
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