title: Preoperative cognitive intervention reduces cognitive dysfunction in elderly patients after gastrointestinal surgery: a randomized controlled trial.
abstract: BACKGROUND
  Preoperative conditions may play a significant role in postoperative cognitive dysfunction (POCD) development in elderly patients. We aimed to investigate whether preoperative cognitive training could lower the incidence of POCD one week after surgery.
  
  
  METHODS
  A total of 141 ASA I-III elderly patients who underwent gastrointestinal surgery were enrolled into the study. Patients were randomized into either the Intervention group (69 analyzed) or the Control group (72 analyzed). Patients in the intervention group were instructed and trained in a cognition mnemonic skill for a total of three 1-hour sessions with the method of loci (MoL). Controls did not receive any cognitive training during hospitalization. All patients were tested using neuropsychological battery tests (NPTs) on admission and one week after surgery.
  
  
  RESULTS
  The incidence of POCD in the intervention group (15.9%) was significantly lower than in the controls (36.1%) (P<0.05). Patients' performance in Brief Visuospatial Memory Test-Revised and Symbol-Digit Modalities Test were improved by the cognitive training. Increasing age, longer length of anesthesia and surgery, and lack of cognitive training were associated with a significantly higher risk of POCD (P<0.05).
  
  
  CONCLUSIONS
  Cognitive training with MoL can reduce the decline of early postoperative cognitive function in elderly patients undergoing major gastrointestinal surgery.
authors.affiliation: Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland).
authors.forename: Amin J
authors.initials: AJ
authors.lastname: Saleh
authors.affiliation: Department of Nurse, Third Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland).
authors.forename: Guan-Xiu
authors.initials: GX
authors.lastname: Tang
authors.affiliation: Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland).
authors.forename: Sally M
authors.initials: SM
authors.lastname: Hadi
authors.affiliation: Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland).
authors.forename: Liao
authors.initials: L
authors.lastname: Yan
authors.affiliation: Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland).
authors.forename: Ming-Hua
authors.initials: MH
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland).
authors.forename: Kai-Ming
authors.initials: KM
authors.lastname: Duan
authors.affiliation: Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland).
authors.forename: Jianbin
authors.initials: J
authors.lastname: Tong
authors.affiliation: Department of Anesthesiology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland).
authors.forename: Wen
authors.initials: W
authors.lastname: Ouyang
mesh_terms: D000368:Aged; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology* / Q000503:physiopathology*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology*; D011300:Preoperative Care; D012307:Risk Factors