• Siyu Duan, Yan Liao, Yujie Tang, Bin Zhang, Mingchao Peng, Jianbin Tong, Wen Ouyang, and Yuan LE.
• Department of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha, China.
• Minerva Anestesiol. 2022 Mar 1; 88 (3): 145-155.

BackgroundTo investigate whether short-term perioperative cognitive therapy combined with rehabilitation exercise decreases the incidence of neurocognitive disorder (NCD) in elderly patients who have undergone hip joint replacement surgery. This was a randomized, parallel controlled trial on elderly patients who underwent unilateral total hip joint replacement surgery at the Third Xiangya Hospital of Central South University.MethodsPatients in the perioperative cognitive therapy combined with rehabilitation exercise group underwent preoperative cognitive training and postoperative cognitive training, rehabilitation exercise, and standardized health care services; the control group received only postoperative standardized health care service. Patients with NCD were defined as those with two or more abnormalities on 11 neuropsychological tests. Of the 607 individuals that we screened, 86 (exercise, 50; control, 36) who completed the study were included.ResultsThe baseline characteristics were similar for the two groups. The incidence of NCD in the exercise group (10%, 5/50) was significantly lower than that in the control group (27.8%, 10/36) (P=0.032). The HVLT-R, HVLT-R delayed recall test, and HVLT-R recognition discriminating index were significantly improved in the exercise group compared with the control group (all P<0.05). Our findings highlight the clinical significance of perioperative cognitive exercise combined with rehabilitation exercise in preventing NCD among patients after surgery and anesthesia.ConclusionsOur study indicates that perioperative cognitive therapy combined with rehabilitation exercise can effectively reduce the incidence of NCD in elderly patients after total hip joint replacement surgery.

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