Effectiveness of cognitive interventions for adult surgical patients after general anaesthesia to improve cognitive functioning: A systematic review.
Tracey Bowden, Catherine S Hurt, Julie Sanders and 1 others
PMID 35733323WHAT IT FOUND
Memory-focused cognitive training after surgery improved memory scores in several small studies, but attention training did not consistently help.
Adherence was 6% immediately after surgery and 90% in another study.
Key findings
01Memory-focused traditional interventions improved memory in all three studies that targeted memory.
02Computerised cognitive interventions improved memory in three studies, but no differences were observed on attention measures.
03Quality of life improved in two studies, and depression scores improved in two studies.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The evidence comes from 9 studies with 511 patients, many small pilot or feasibility studies, so the results are not strong enough to prove a treatment works. No meta-analysis was possible because surgeries, intervention timing, dose, and cognitive tests varied too much. Risk of bias was high in several studies: five of six randomised trials did not blind participants or investigators, and some non-randomised studies lacked recruitment, outcome assessor, attrition, or intervention details. Poor-quality studies were kept in the review, so weak evidence influenced the narrative. Adherence varied from 6% to 90%, and only one study measured whether patients accepted the intervention. Five studies excluded patients with lower baseline cognitive test scores, so findings may not apply to patients already at higher cognitive risk.
Declared interests
The authors declared no conflicts of interest. The review was funded by Barts Charity and City, University of London.
The easy way to misread this
Do not read this as proof that cognitive training reliably prevents or treats postoperative cognitive dysfunction. The review is based on small, heterogeneous pilot and feasibility studies, several with high risk of bias, and no meta-analysis was possible. Memory gains were inconsistent across tests, attention outcomes were mostly null, and immediate postoperative adherence was very low.