The effect of perioperative cognitive training on postoperative delirium in older patients undergoing total hip and knee arthroplasty: a prospective randomised trial

Understanding the Study on Cognitive Training and Postoperative Delirium

Objective

This study aimed to find out if cognitive training (CT) can help reduce postoperative delirium (POD) in older patients who had total hip and knee surgeries.

Methods

The clinical trial took place from February 18 to July 10, 2023. It included patients aged 60 to 79 who were having elective hip and knee surgeries lasting no longer than 3 hours under general anesthesia. Patients with cognitive issues or dementia were not included. The main goal was to compare the rates of POD between those who received cognitive training and those who only received routine care.

Results

A total of 122 patients participated and were split into two groups. The overall rate of POD was 8.2%, with 10 patients affected. There was no significant difference in POD rates between the two groups (9.8% in the CT group versus 6.6% in the routine care group). Secondary outcomes such as adverse events and postoperative pain also showed no significant differences. It was noted that very few patients (4%) complied with the recommended cognitive training sessions. Interestingly, among those who did participate, fewer training sessions were linked to a higher incidence of POD.

Conclusion

The study suggests that cognitive training may not reduce the risk of POD in older patients undergoing these surgeries. The results indicate that following the recommended number of CT sessions could be important in managing POD.

Practical Healthcare Opportunities

  • Focus on improving compliance with cognitive training programs for better outcomes.
  • Monitor and evaluate the duration and frequency of cognitive training sessions.
  • Consider individual patient needs when implementing cognitive training in clinical practice.

Steps for Implementation

1. Set clear goals for reducing POD based on this study’s findings.

2. Choose AI tools that can assist in monitoring and evaluating cognitive training compliance.

3. Start with a pilot project to test the effectiveness of cognitive training in a clinical setting.

4. Use feedback and data from real-world impacts to refine approaches.

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