Prospective Randomized Controlled Trial of VR Cognitive Training in Reducing Postoperative Delirium in Elderly Patients With Cerebral Small Vessel Disease Undergoing Non-Cardiac Surgery

Launched by PEKING UNIVERSITY THIRD HOSPITAL · May 22, 2025

Keywords

ClinConnect Summary

This clinical trial is exploring whether using virtual reality (VR) cognitive training can help prevent a condition called postoperative delirium (POD) in older patients who have a specific brain condition known as cerebral small vessel disease (CSVD) and are scheduled for non-cardiac surgery. POD can cause confusion and memory problems after surgery, leading to longer hospital stays and an increased risk of developing serious conditions like Alzheimer's disease. The study will involve patients aged 65 and older who are having surgeries that last more than two hours. Participants will use an innovative VR system that includes fun games and cognitive exercises designed to improve their thinking and memory skills before their surgery.

To be eligible for this trial, participants must be at least 65 years old, have a confirmed diagnosis of CSVD through an MRI scan, and be scheduled for general anesthesia for a non-cardiac procedure. They should also not have any serious visual or hearing issues and must be able to complete some simple cognitive tests. During the trial, participants can expect to engage with the VR training and undergo assessments to see if this approach can help protect their brain health during recovery from surgery. This research could provide valuable insights into new ways to support older patients during and after surgery.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age ≥ 65 years; Preoperative MRI diagnosis of cerebral small vessel disease (CSVD); Scheduled to undergo non-cardiac, non-intracranial procedures under general anesthesia; Expected surgery duration \> 2 hours; ASA physical status classification: I-III; No use of cognitive-enhancing medications within 3 months prior to surgery; Willing to participate and provide written informed consent.
• Exclusion Criteria:
• • Contraindications to cranial MRI (e.g., cardiac pacemaker, metallic implants, etc.); Patients experiencing subjective discomfort (dizziness, nausea, vomiting) during VR device adaptation; Severe visual or auditory impairment; Severe hepatic or renal dysfunction; Pre-existing neuropsychiatric disorders (schizophrenia, epilepsy, Parkinson's disease, delirium, etc.); Inability to complete preoperative neuropsychological assessments (dementia, deaf-mutism, communication disorders); History of cerebrovascular events (stroke, transient ischemic attack, etc.) within 3 months prior to surgery; Current use of sedatives/antidepressants or history of psychoactive substance abuse/alcoholism.