protocolSection identificationModule nctId: NCT06339268, orgStudyIdInfo id: MMABelgrade, briefTitle: Cognitive and Physical Optimization in Prevention of Postoperative Cognitive Deficit in Elderly With Lung Resection, acronym: COGNITION, statusModule overallStatus: RECRUITING, startDateStruct date: 2023-11-01, primaryCompletionDateStruct date: 2025-11-01, completionDateStruct date: 2026-03-01, studyFirstPostDateStruct date: 2024-04-01, lastUpdatePostDateStruct date: 2024-04-01, sponsorCollaboratorsModule leadSponsor name: Military Medical Academy, Belgrade, Serbia, class: OTHER, descriptionModule briefSummary: Postoperative cognitive deficit and its connection with surgery and general anesthesia were first mentioned in the literature in 1955 by Bradford. Cognitive disorders in the postoperative period are postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). POD is an acute dysfunction in cognition, which did not exist preoperatively. Attention deficit disorder is the main symptom of POD and refers to the inability to direct, focus, maintain, or shift attention. Memory impairment, disorientation, or perceptual disturbances may also be present. Cognitive capacity changes in POD patients develop and fluctuate in the first few days after surgery. Unlike POD, there is no formal definition for POCD. Based on data from the existing literature, it is defined as newly diagnosed cognitive deterioration that occurs after surgery. The diagnosis of POCD should be based on pre- and postoperative screening with appropriate psychometric tests. Risk factors for the development of POCD include those related to the surgical procedure, anesthesia, or the patient himself. Compared to less invasive and shorter operations, there is a higher risk of developing POCD after major, invasive, and long-term operations. Additional risk factors are intraoperative (intraoperative bleeding, perioperative transfusion treatment, hypotension) and postoperative complications (respiratory insufficiency, pneumonia, atelectasis, bronchospasm, bronchopleural fistula, and pulmonary edema). Presurgical optimization (Prehabilitation) is a widespread concept that aims to improve the general condition of the patient or optimize comorbidities before major surgery. Prehabilitation is primarily focused on improving physical ability and nutritional status, but it is developing in the direction of a multimodal approach that includes measures to reduce stress and anxiety. Psychological factors are increasingly recognized as an essential element of prehabilitation and are often added to prehabilitation programs.Older patients, who meet the diagnostic criteria for frailty and are at risk of developing postoperative complications such as cognitive function disorders are increasinglyundergoing lung resection. These complications can affect the outcome and speed of postoperative recovery., conditionsModule conditions: Prehabilitation, designModule studyType: INTERVENTIONAL, phases: NA, designInfo allocation: RANDOMIZED, interventionModel: PARALLEL, interventionModelDescription: After setting the indication for operative treatment, patients who meet the criteria for inclusion in the study, after signing the informed consent, will be randomized into two groups:1. The first group (intervention) where the patient will receive preoperative cognitive stimulation and physical therapy for one month before surgical treatment.2. The second group (control) where patients receive standard treatment., primaryPurpose: PREVENTION, maskingInfo masking: NONE, enrollmentInfo count: 120, type: ESTIMATED, armsInterventionsModule interventions name: Cognitive training, CogniFit App, outcomesModule primaryOutcomes measure: Postoperative cognitive dysfunction, primaryOutcomes measure: Perioperative depression and anxiety, primaryOutcomes measure: Postoperative delirium, primaryOutcomes measure: Functional status and postoperative recovery, primaryOutcomes measure: Functional status and postoperative recovery, primaryOutcomes measure: Postoperative recovery, primaryOutcomes measure: Functional status and postoperative recovery, secondaryOutcomes measure: Overall outcome: Complication rate, secondaryOutcomes measure: Overall outcome: Morbidity, secondaryOutcomes measure: Overall outcome: Mortality, eligibilityModule sex: ALL, minimumAge: 60 Years, stdAges: ADULT, stdAges: OLDER_ADULT, contactsLocationsModule locations facility: Military Medical Academy, status: RECRUITING, city: Belgrade, zip: 11000, country: Serbia, contacts name: Vojislava Neskovic, PhD, role: CONTACT, phone: +381 64 1775 320, email: vojkan43@gmail.com, contacts name: Marija Markovic, MD, role: CONTACT, phone: +381 62 666653, email: markovicmarija@hotmail.com, geoPoint lat: 44.80401, lon: 20.46513, hasResults: False