VR-Based Cognitive Stimulation Games for Delirium Prevention

This trial aims to evaluate the feasibility, safety, and acceptability of a virtual reality (VR)-based cognitive stimulation game to reduce postoperative delirium among older surgical patients at high risk due to pre-existing cognitive impairment.

Inclusion Criteria: * Men and women ≥65 years of age * Have a pre-existing diagnosis of cognitive impairment (Montreal Cognitive Assessment Score of 15-24) * Elective or emergency major surgery with the expectation of admission to the Intensive Care Unit following the surgery for three days following surgery Exclusion Criteria: * Pre-existing Intubation and invasive ventilation; * history of severe mental illness; * admission for a drug overdose; * severe vertigo; * history of severe postoperative nausea and vomiting; * hearing and visual impairment; * preexisting severe dementia (Montreal Cognitive Assessment Score \< 15; and * active delirium at the time of screening for eligibility criteria. * Active suicidal ideation or behavior Screen failure after surgery * Prolonged intubation after surgery (more than 24 hours)