Effects of cognitive training on cognitive function in patients after cardiac surgery: A systematic review and meta-analysis of randomized controlled trials DOI Creative Commons
R C Zhang, Chenyang Zhu, Shiqi Chen

et al.

Medicine, Journal Year: 2024, Volume and Issue: 103(44), P. e40324 - e40324

Published: Nov. 1, 2024

Background: Postoperative cognitive deficits frequently occur in patients undergoing cardiac surgery, leaving them with reduced function. Cognitive training has been shown to improve function, however, the role after surgery is unclear. In this study, we aimed evaluate effectiveness and safety of surgery. Method: A systematic search PubMed, Embase, Cochrane Library, CINAHL, Ovid Medline, Web Science, CNKI, Wanfang was conducted until March 2024. The risk bias assessed using Risk Bias Tool. Data were meta-analyzed RevMan 5.4 software. Potential reliability evidence fairly by method GRADE grading method. Results: total 16 studies involving 1335 included study. Compared control group, group had a significantly lower incidence postoperative dysfunction (RR 0.35, 95% CI 0.18–0.65, P = .001), improved function (MD 2.54, 1.27–3.81, < higher quality life-mental component 5.22, 2.32–8.13, anxiety −6.05, −10.96 −1.15, .02) depression −3.97, −7.15 −0.80, .01) between groups. However, differences not statistically significant for delirium 1, 0.38–2.65, 1.00) hospitalization −0.95, −2.90 1.00, .34). Conclusions: present based on low moderate evidence, suggests that improves functioning, reduces dysfunction, positive impact current does allow determination effects life, delirium, length stay.

Language: Английский

The research progress of perioperative non-pharmacological interventions on postoperative cognitive dysfunction: a narrative review DOI Creative Commons
Li Zhao, Yiping Guo, Xuelei Zhou

et al.

Frontiers in Neurology, Journal Year: 2024, Volume and Issue: 15

Published: May 1, 2024

Postoperative cognitive dysfunction (POCD) is a common neurological complication in elderly patients after surgery and general anesthesia. The occurrence of POCD seriously affects the postoperative recovery patients, leads to prolonged hospital stay, reduced quality life, increased medical costs, even higher mortality. There no definite effective drug treatment for POCD. More evidence shows that perioperative non-pharmacological intervention can improve function reduce incidence Therefore, our studies summarize current interventions from aspects training, physical activity, transcutaneous electrical acupoint stimulation, noninvasive brain sleep improvement, music therapy, environment, multimodal combination Interventions, provide more data clinical application research.

Language: Английский

Citations

4
The Role of Cytokines in Perioperative Neurocognitive Disorders: A Review in the Context of Anesthetic Care DOI Creative Commons
Hyun Jung Koh, Jin Joo

Biomedicines, Journal Year: 2025, Volume and Issue: 13(2), P. 506 - 506

Published: Feb. 18, 2025

Perioperative neurocognitive disorders (PNDs), including postoperative delirium, delayed recovery, and long-term disorders, present significant challenges for older patients undergoing surgery. Inflammation is a protective mechanism triggered in response to external pathogens or cellular damage. Historically, the central nervous system (CNS) was considered immunoprivileged due presence of blood-brain barrier (BBB), which serves as physical preventing systemic inflammatory changes from influencing CNS. However, aseptic surgical trauma now recognized induce localized inflammation at site, further exacerbated by release peripheral pro-inflammatory cytokines, can compromise BBB integrity. This breakdown facilitates activation microglia, initiating cascade neuroinflammatory responses that may contribute onset PNDs. review explores mechanisms underlying neuroinflammation, with particular focus on pivotal role cytokines pathogenesis

Language: Английский

Citations

0
Postoperative Delirium and Neurocognitive Disorders: A Comprehensive Review of Pathophysiology, Risk Factors, and Management Strategies DOI Open Access

Sharayu Paunikar,

Vivek Chakole

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 2, 2024

Postoperative delirium (POD) and neurocognitive disorders (NCDs) are common serious complications that can occur after surgery, particularly in older adults those with preexisting cognitive impairments. These conditions associated significant morbidity, increased healthcare costs, reduced quality of life. Understanding the underlying mechanisms, risk factors, effective management strategies for POD NCDs is critical improving patient outcomes reducing burden on systems. This comprehensive review aims to synthesize current knowledge pathophysiology, NCDs. It explores neurobiological molecular mechanisms contributing these conditions, identifies patient-related, surgical, environmental factors increase risk, evaluates pharmacological non-pharmacological approaches prevention treatment. A thorough literature was conducted using recent studies, clinical guidelines, expert consensus provide a detailed overview presentation, prevention, The pathophysiology involves complex interactions between neuroinflammatory processes, neurotransmitter imbalances, brain network disruptions. Risk include advanced age, impairment, type duration perioperative complications. Management emphasize multidisciplinary approach, incorporating preoperative optimization, careful intraoperative management, postoperative interventions. Pharmacological treatments, such as antipsychotics, approaches, including modifications rehabilitation, play crucial roles management. multifactorial impacts surgical outcomes. Effective requires understanding their implementation targeted treatment strategies. Future research should focus personalized treatment, further elucidation developing predictive models enhance care patients at

Language: Английский

Citations

2
The clinical value of nonpharmacological interventions for preventing postoperative delirium: a narrative review DOI
Ting Li, Zhen Feng, Yan Hou

et al.

Minerva Anestesiologica, Journal Year: 2024, Volume and Issue: 90(9)

Published: Sept. 1, 2024

Postoperative delirium (POD) is a prevalent perioperative complication among elderly individuals and cause of significant detrimental consequences for both society. Pharmacological nonpharmacological prevention methods/therapies have been proposed to mitigate the risk POD. Nevertheless, efficacy pharmacological interventions controversial, some them side effects. Therefore, numerous studies explored effectiveness in mitigating POD recommended use multicomponent by an interdisciplinary team as primary interventions. However, dedicated units aimed at promoting comanagement are rare only present academic hospitals. there increasing interest mono-component preventing POD, which offer advantages such easy application, cost-effectiveness, patient acceptability noninvasiveness. These divided into cognitive training noncognitive The former reserve, thus decreasing incidence rate Noncognitive interventions, including sensory stimuli (music therapy, odor enrichment), improving sleep disturbances, physical activity, acupuncture transcranial magnetic/direct current stimulation, factors This review provides comprehensive overview recently reported briefly describes their clinical value.

Language: Английский

Citations

2
Current perspectives on postoperative cognitive dysfunction in geriatric patients: insights from clinical practice DOI Creative Commons
Liang Zhang,

Yi Lan Qiu,

Zhifeng Zhang

et al.

Frontiers in Medicine, Journal Year: 2024, Volume and Issue: 11

Published: Sept. 27, 2024

Postoperative cognitive dysfunction (POCD) is a common and serious postoperative complication in elderly patients, affecting function quality of life. Its pathophysiology complex, involving age-related decline, surgical anesthetic factors, systemic neuroinflammation, as well genetic environmental contributors. Comprehensive preoperative assessment optimization, the selection appropriate agents, minimally invasive techniques, early rehabilitation training are effective strategies to reduce incidence POCD. Recent research suggests that anti-inflammatory drugs neuroprotective agents may be promising preventing Additionally, non-pharmacological interventions, including physical training, have shown positive effects. Future directions should include large-scale clinical trials mechanistic studies further understand manage POCD, along with integrating new findings into practice. Continuous education for healthcare professionals essential ensure application latest patient care. Through multidisciplinary collaboration ongoing improvements, these efforts can significantly enhance life patients.

Language: Английский

Citations

2
Contemporary Incidence of Cognitive Impairment or Dementia in Patients Undergoing Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis DOI Creative Commons

Hui Zhen Lo,

Caitlin Fern Wee, Chen Ee Low

et al.

Dementia and Geriatric Cognitive Disorders, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 15

Published: July 24, 2024

Despite the high prevalence of cognitive impairment or dementia post-coronary artery bypass grafting (CABG), incidence post-CABG in contemporary practice is currently unclear. Therefore, this paper aims to investigate and associated risk factors patients' post-CABG.

Language: Английский

Citations

1
Cognitive prehabilitation for older adults undergoing elective surgery: a systematic review and narrative synthesis DOI Creative Commons
Yu He, Ziliang Wang,

Yinuo Zhao

et al.

Frontiers in Aging Neuroscience, Journal Year: 2024, Volume and Issue: 16

Published: Oct. 4, 2024

Background Perioperative cognitive maintenance and protection in older adults is an important patient safety imperative. In addition to foundational care, one area of growing interest integrating prehabilitation into the surgical trajectory. This review aimed evaluate effectiveness on functional capacity postoperative outcomes among undergoing elective surgery. Methods The MEDLINE, Embase, CENTRAL, CINAHL, PsycINFO, PEDro, CBM, CNKI, WANFANG, VIP databases were systematically searched up September 5, 2024, identify randomized controlled trials published for English or Chinese. Two authors independently completed study selection process, data extraction process methodological quality assessment. Patient, Intervention, Comparison, Outcome, Study design framework was used construct search strategy. predefined primary included incidence delirium (POD) delayed neurocognitive recovery (dNCR). studies evaluated by PEDro scale. Owing small number clinical diversity, a narrative synthesis undertaken accordance with Synthesis Without Meta-analysis guidelines. conducted reported Preferred Reporting Items Systematic Reviews Meta-analyses statement. certainty evidence assessed using Grading Recommendations Assessment, Development Evaluation system. Results Six analysed. These involved 645 total participants, 316 intervention group (mean age, 66.0–73.8 years; 38.4–77.8% male) 329 comparator 67.5–72.6 31.8–88.9% male). effects preoperative training reducing dNCR, POD, length hospital stay postsurgical complications as well improving global function activities daily living are quite uncertain. results this should be interpreted caution owing limited low very evidence. Conclusion Current noncognitive patients surgery unclear. registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=277191 , Identifier CRD42021277191.

Language: Английский

Citations

1
Effects of cognitive training on cognitive function in patients after cardiac surgery: A systematic review and meta-analysis of randomized controlled trials DOI Creative Commons
R C Zhang, Chenyang Zhu, Shiqi Chen

et al.

Medicine, Journal Year: 2024, Volume and Issue: 103(44), P. e40324 - e40324

Published: Nov. 1, 2024

Background: Postoperative cognitive deficits frequently occur in patients undergoing cardiac surgery, leaving them with reduced function. Cognitive training has been shown to improve function, however, the role after surgery is unclear. In this study, we aimed evaluate effectiveness and safety of surgery. Method: A systematic search PubMed, Embase, Cochrane Library, CINAHL, Ovid Medline, Web Science, CNKI, Wanfang was conducted until March 2024. The risk bias assessed using Risk Bias Tool. Data were meta-analyzed RevMan 5.4 software. Potential reliability evidence fairly by method GRADE grading method. Results: total 16 studies involving 1335 included study. Compared control group, group had a significantly lower incidence postoperative dysfunction (RR 0.35, 95% CI 0.18–0.65, P = .001), improved function (MD 2.54, 1.27–3.81, < higher quality life-mental component 5.22, 2.32–8.13, anxiety −6.05, −10.96 −1.15, .02) depression −3.97, −7.15 −0.80, .01) between groups. However, differences not statistically significant for delirium 1, 0.38–2.65, 1.00) hospitalization −0.95, −2.90 1.00, .34). Conclusions: present based on low moderate evidence, suggests that improves functioning, reduces dysfunction, positive impact current does allow determination effects life, delirium, length stay.

Language: Английский

Citations

0