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WithdrawnNCT05796830Updated Oct 2, 2026

Determination of the Effect of Puzzle Use in Elderly Patients

An interventional study of Puzzle application in Quality of Life, Surgery and Postoperative Confusion, sponsored by Saglik Bilimleri Universitesi. Withdrawn. Open to participants aged 65 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-10-02.

Sponsored by Saglik Bilimleri Universitesi · Not applicable, Interventional, and Other

Why this study was withdrawn
The study investigator (graduate student) discontinued their academic program, and the study was cancelled before any participant enrollment.
Updated Oct 2, 2026Now WithdrawnEnrollment updatedGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
0
Allocation
Randomized
Ages
65 Years and older
Sex
All
01

Study summary

The aim of this study is to determine the effects of the use of a simple, reliable and cost-effective puzzle on post-operative cognitive function changes, postoperative recovery, and quality of life using questionnaires and face-to-face interview techniques.

Read the detailed description

Aging is a process involving biological, physiological and psychological changes. With aging, deterioration in brain, behavior and cognitive functions is observed. In this process, physical and cognitive deficiencies and slow thinking can be seen. The independence of elderly individuals in meeting their self-care decreases. Over time, individuals become unable to meet their needs and this reduces the quality of life of individuals. With the developing technology, perioperative care techniques began to develop and the number of surgical procedures applied to elderly patients began to increase.One of the most important goals in the field of health today and in the future will be to increase the quality of life of individuals. It is becoming increasingly important to determine the effective factors to protect cognitive functions in elderly individuals.After surgical procedures, patients may experience memory loss and decrease in concentration. Symptoms indicating a decrease in cognitive functions were named as postoperative cognitive dysfunction. Compared to other individuals undergoing surgery, the rate of cognitive changes in the early period is higher in the elderly.Especially, elderly patients who underwent orthopedic surgery are thought to be a risky patient group for postoperative cognitive impairment.Solving jigsaw puzzles is a low-cost, motivating, visuospatial cognitive-challenging activity.This study will be conducted in order to determine the effect of this strain on the cognitive functions of the individual and to investigate the effect of focusing on completing the puzzle on post-operative recovery and quality of life, as it will focus the individual's perception on a certain point.

02

Conditions studied

  • Quality of Life
  • Surgery
  • Postoperative Confusion
  • Cognitive Dysfunction

Keywords

  • Postoperative Recovery
  • Cognitive Function
  • Surgery
  • Quality of Life
  • Elderly Patient
03

In context

Cognitive Dysfunction

3,843 studies on the registry are indexed under Cognitive Dysfunction; 1,099 are open to participants now.

Browse Cognitive Dysfunction studies →

Lead sponsor

Saglik Bilimleri Universitesi is the lead sponsor of 430 studies on the registry; 137 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
65 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • 65 years and older,
  • Having been hospitalized in the orthopedic service for at least three days after the operation,
  • Having undergone orthopedic surgery,
  • No hearing or vision problems,
  • Able to communicate,
  • No cognitive or psychiatric problems,
  • At least primary school graduate,
  • Patients who agreed to participate in the study

Exclusion criteria

Exclusion Criteria:

  • Using jigsaw puzzles regularly,
  • Using drugs that affect memory and thinking

These drugs are:

  1. Sedative and Hypnotic Drugs

    • Benzodiazepines
    • Barbiturates
    • Non-barbiturate
    • Other Sedative and Hypnotics (zolpidem, buspirone, hydroxyzine)
  2. Anticonvulsant Drugs
  3. Drugs Used in Parkinson's Treatment
  4. Drugs Used in the Treatment of Psychiatric Diseases
  5. Drugs with Narcotic Analgesic Effects
  6. Anesthetic Drugs
  7. Neuromuscular Blocking Drugs - Patients with cerebrovascular accident or head injury
05

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
0 participants (actual)

Study arms

  • Active comparator
    Intervention Group

    Before the operation, the rules of the puzzle will be explained to the patients in the intervention group and how it will be applied will be shown. Then, Patient Diagnosis Form, Mini-Mental State Test and Quality of Life Scale will be administered.On the 1st, 2nd and 3rd days after the surgery, the rules of the puzzle will be reminded again and the puzzle will be applied to the patients once a day. After the puzzle application on the 1st, 2nd and 3rd days after the surgery, the Mini-Mental State Test will be applied to the patients. Postoperative Recovery Index and Quality of Life Scale will be applied on the 3rd postoperative day.

    Other: Puzzle application

  • No intervention
    Control Group

    Patients in the control group will be followed according to routine clinical procedure. Since there are no procedures or interventions in clinical procedures, only patient monitoring will be performed. The patients in the control group will also be followed and evaluated with the same forms at the same time.

Interventions

  • OtherPuzzle application

    Five expert opinions will be taken for the puzzle application to be applied after the surgery, and the application and difficulty level of the puzzle will be decided.

06

What researchers measure

Primary outcomes

  1. Change of Cognitive Function by the Standardized Mini-Mental Test

    1st, 2nd and 3rd days after the surgery, the puzzle will be applied to the patients once a day. Then the Standardized Mini-Mental Test will be applied to the patients.This test is a measurement tool that can be easily administered within 5-10 minutes, does not include questions about mental processes, and focuses only on cognitive processes.The Standardized Mini Mental Test consists of 11 items under 5 main headings: orientation (10 points), attention and calculation (5 points), recording (3 points) and recall memory (3 points) and language (9 points). It is evaluated out of 30 points. The increase in the score obtained from the test indicates that the severity of cognitive destruction decreases.

    Time frame: 1st, 2nd and 3rd days after the surgery

  2. Change of Postoperative Recovery by the Postoperative Recovery Index

    Postoperative Recovery Index will be applied on the 3rd postoperative day. Postoperative Recovery Index consists of 5 sub-dimensions and 25 items. Sub dimensions; psychological symptoms, physical activities, general symptoms, intestinal symptoms, and craving-desire symptoms. While determining the sub-dimension score, the scores of the related items are summed and their arithmetic averages are taken. For the total score; All items are summed and the arithmetic average is taken. It states that the higher the scores obtained from the index, the more difficulty in post-operative recovery, and the easier the post-operative recovery as the scores decrease.

    Time frame: 3rd day after the surgery

  3. Change of Quality of Life by Quality of Life Scale in Older People (CASP-19)

    Quality of Life Scale in Older People (CASP-19) will be applied on the 3rd postoperative day. The scale consists of 19 items and four sub-dimensions. These sub-dimensions are control, autonomy, pleasure, and self-actualization. Each item of the original scale was graded as a 4-point Likert-type scale ranging from "never" (0 points) to "always" (3 points). Scale items are scored between 0 and 3 points. An increase in the score obtained from the scale indicates an increase in the quality of life.

    Time frame: 3rd day after the surgery

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Rundshagen I. Postoperative cognitive dysfunction. Dtsch Arztebl Int. 2014 Feb 21;111(8):119-25. doi: 10.3238/arztebl.2014.0119. PubMed 24622758 ↗
  • Fissler P, Kuster OC, Loy LS, Laptinskaya D, Rosenfelder MJ, von Arnim CAF, Kolassa IT. Jigsaw Puzzles As Cognitive Enrichment (PACE) - the effect of solving jigsaw puzzles on global visuospatial cognition in adults 50 years of age and older: study protocol for a randomized controlled trial. Trials. 2017 Sep 6;18(1):415. doi: 10.1186/s13063-017-2151-9. PubMed 28877756 ↗

Individual participant data

Plan to share: No

09

Updates

1 registry update since Sep 25, 2026
Status
Status unknown→Withdrawn The study investigator (graduate student) discontinued their academic program, and the study was cancelled before any participant enrollment.
changed Oct 2, 2026
Enrollment
70 (estimated)→0 (actual)
Oct 2, 2026
Show all 1 update
  1. Oct 2, 2026
    Status unknown→Withdrawn
    Why stopped The study investigator (graduate student) discontinued their academic program, and the study was cancelled before any participant enrollment.
    Enrollment 70 (estimated)→0 (actual)
    + 5 other changes: verification date, responsible party, conditions, contact details and index terms

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT05796830
Lead sponsor
Saglik Bilimleri Universitesi
Responsible party
Elif Gezginci Akpinar (Assoc. Prof, Saglik Bilimleri Universitesi) — Principal investigator
First posted
Apr 4, 2023
Start date
Mar 28, 2023 (estimated)
Primary completion
Oct 29, 2023 (estimated)
Completion
Dec 29, 2023 (estimated)
Last update
Oct 2, 2026

Study contacts

Emel Çanakçı, RN
principal investigator · Saglik Bilimleri Universitesi

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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