cognitive-prehab
title

Cognitive prehabilitation for postoperative cognitive impairment in surgical patients

Eligibilityinclusion · exclusion
include · 6
Adults (≥18 years)
Population undergoing elective surgery
Study evaluates at least one of: cognitive training or cognitive prehabilitation
Comparator is standard perioperative care or sham cognitive intervention
Randomized controlled trials or comparative observational studies
Primary research published in peer-reviewed journals
exclude · 6
Case reports
Editorials
Commentaries
Letters
Narrative reviews
Animal studies
Search strategy2 groups (AND across, OR within)
group 1 · 12 terms (OR)
cognitive prehabilitationcognitive trainingperioperative cognitive trainingpreoperative cognitive trainingpostoperative cognitive trainingcognitive exercisecognitive exercisesbrain trainingcognitive interventionneurocognitive trainingcognitive rehabilitationmental training
and
group 2 · 10 terms (OR)
surgerysurgicalperioperativepreoperativepostoperativeelective surgeryoperationoperativeanesthesiaanaesthesia
Axis
identification

Locate the arms in randomization tables, methods sections describing allocated interventions, or table column headers. Dimension (categorical) — the assigned cognitive intervention or control condition.

arm · cognitive_training

Cognitive training or prehabilitation comprising any practice or training (games, puzzles, tasks, or other interventions) implemented in the pre-, peri-, and/or post-operative period with the goal of improving or safeguarding cognitive function, including 'cognitive prehabilitation', 'perioperative cognitive training', 'cognitive exercises', and 'brain training'. Distinguished from sham_control by adaptive difficulty or an explicit therapeutic cognitive aim.

arm · standard_care

Standard perioperative care without cognitive training or prehabilitation, including 'usual care', 'routine care', 'no cognitive intervention', and 'standard of care'. Distinguished from sham_control by the absence of any delivered task or attention-matched activity.

arm · sham_control

Non-therapeutic, non-adaptive task designed to match the training group's engagement, attention, and contact time without the adaptive cognitive load that defines the intervention, including 'sham training', 'placebo cognitive training', 'active control', and 'attention control'. Distinguished from standard_care by a delivered task, and from cognitive_training by absent adaptive difficulty or therapeutic aim.

Outcomes2 primary · 4 secondary
primary · 2
delayed_neurocognitive_recoveryIncidence of delayed neurocognitive recovery per the 2018 Nomenclature Consensus Working Group, defined as a decrease of at least one standard deviation or the minimal clinically important difference on a validated cognitive test, or transition from preoperatively normal to postoperatively impaired function; assessed at postoperative day 7 or the nearest date between postoperative days 3 and 30.
postoperative_neurocognitive_disorderIncidence of mild or major postoperative neurocognitive disorder per the 2018 Nomenclature Consensus Working Group, defined as a decrease of at least one standard deviation or the minimal clinically important difference on a validated cognitive test, or transition from preoperatively normal to postoperatively impaired function; assessed at postoperative month 6 or the nearest date between postoperative months 1 and 12.
secondary · 4
postoperative_deliriumIncidence of postoperative delirium prior to hospital discharge measured with a validated instrument; binary outcome.
executive_functionContinuous measures of executive function on validated cognitive instruments.
global_cognitive_functionScores on a global cognitive battery or screening instrument (MoCA, MMSE, or a composite neuropsychological z-score), as reported.
cognitive_test_performanceScores on a domain-specific validated cognitive test outside executive function, covering memory, attention, or processing speed.