Key result
Perioperative cognitive training significantly reduced the incidence of postoperative cognitive dysfunction compared to control (RR 0.50), but had no significant effect on postoperative delirium.
Why the study?
Randomized controlled trials showed conflicting results regarding the effects of perioperative cognitive training on postoperative cognitive dysfunction and postoperative delirium.
Does perioperative cognitive training reduce the incidence of postoperative cognitive dysfunction and postoperative delirium in surgical patients?
Systematic Review (n=975)
Does perioperative cognitive training reduce the incidence of postoperative cognitive dysfunction and postoperative delirium in surgical patients?
Relative Risk: 0.5 (95% CI 0.28–0.89)
p-value: p=0.02
Perioperative cognitive training significantly reduces the incidence of postoperative cognitive dysfunction, but does not significantly affect postoperative delirium.
Supports perioperative cognitive training to reduce postoperative cognitive dysfunction; extends mixed RCT-cohort evidence while leaving delirium prevention unresolved.
Background Randomized 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. Methods We 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. Results This 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). Conclusion Our 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 registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022371306 , identifier: CRD42022371306.
No takes yet. Share an insight, caveat, or question.
Zhao et al. (2023) conducted a systematic review in Postoperative cognitive dysfunction (POCD) and postoperative delirium (POD) (n=975). Perioperative cognitive function training vs. Standard care without cognitive training was evaluated on Incidence of postoperative cognitive dysfunction (POCD) (RR 0.50, 95% CI 0.28-0.89, p=0.02). Perioperative cognitive training significantly reduced the incidence of postoperative cognitive dysfunction compared to control (RR 0.50), but had no significant effect on postoperative delirium.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: