Current perspectives on postoperative cognitive dysfunction in the aging population [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-75299

Current perspectives on postoperative cognitive dysfunction in the aging population

Ivan Urits1, Vwaire Orhurhu1, Mark Jones1, Dylan Hoyt2, Allison Seats2, Omar Viswanath3
1Harvard Medical School, Beth Israel Deaconess Medical Center, Department of Anaesthesia, Critical Care, and Pain Medicine, Boston, MA
2Creighton University School of Medicine - Phoenix Regional Campus, Phoenix, AZ
3Valley Anaesthesiology and Pain Consultants, University of Arizona College of Medicine-Phoenix, Department of Anaesthesia, Phoenix, AZ, Creighton University School of Medicine, Department of Anesthesia, Omaha, NE

Postoperative cognitive dysfunction (POCD) is defined as a prolonged impairment in cognitive function within weeks to months of an operational procedure. It is especially prevalent in the elderly population, leading to increased morbidity and mortality. As anaesthetic and surgical care continues to improve and become even safer, significantly more older patients are having elective surgical procedures today, yet this comes with an increased risk of POCD as they go through the perioperative phases. Though the pathophysiology behind the development of POCD is still under investigation, current causative mechanisms include mode of anaesthesia administered, anaesthetic used, cerebral hypoperfusion, hyperventilation, and neuroinflammation. These findings lend insight into the importance of being cognizant of the higher likelihood of POCD in at-risk patients including the elderly and taking precaution to include preoperative and postoperative cognitive testing, careful monitoring during anaesthesia, blood pressure control and early treatment of postoperative complications as they arise. In this review, we provide an update on the current understanding of the pathophysiology leading to POCD, identifying risk factors, prevention, and treatment strategies, with a specific focus on the elderly population.

Keywords: Anesthesia, geriatrics, postoperative cognitive dysfunction, aging, postoperative delirium, frailty

Corresponding Author: Ivan Urits, United States

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