Abstract
BACKGROUND: Postoperative cognitive dysfunction (POCD) can develop from 7 days to 1 year after surgery. It is a long-lasting disorder that affects various cognitive domains, including memory, executive function, attention, verbal fluency, and visuospatial performance. Mild symptoms are often overlooked or misinterpreted as signs of normal ageing. The impact of POCD on recovery and quality of life after surgery is not fully understood. This study aims to assess the effects of preoperative cognitive and physical training on postoperative cognitive outcomes and recovery in elderly patients undergoing lung resection. METHODS: Patients who meet the inclusion criteria, after signing the informed consent, are randomized into: (1) The Intervention group: patients receive preoperative cognitive stimulation and physical training from the inclusion until scheduled surgery. (2) The Control group: patients receive standard treatment. Patients from the Intervention group will be assessed for cognitive status and subjected to structured cognitive training at least three times a week for a minimum of 20 min (from the moment of study inclusion, until surgery, targeting 1 month). In addition, after testing for frailty, mobility, and physical reserve, in consultation with a physiotherapy specialist, these patients will be instructed and allocated to structured physical training (breathing exercises, walking, climbing stairs). Patients will keep a diary of preoperative activities that will be overviewed by researchers. The analysis will be performed for the effects of the training on the postoperative cognitive decline of the individual patient (self-control) as well as compared to the control group that will be tested for cognitive status, frailty, and functional reserve but will not be subjected to any intervention. DISCUSSION: Postoperative cognitive deficit represents a risk of prolonged postoperative recovery and reduced quality of life. It is assumed that early recognition and management of possible perioperative risk factors could prevent it. However, despite numerous studies, postoperative cognitive dysfunction remains poorly defined and insufficiently understood. Effective preventive strategies are not defined yet. The objective of this trial is to investigate if preoperative cognitive training and physical exercise may prevent postoperative cognitive decline and improve the quality of postoperative recovery. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06339268.