Postoperative cognitive dysfunction in the elderly.
Despite improvement in surgical techniques, anesthetic management, and intensive care, a significant number of elderly patients develop postoperative cognitive decline. Postoperative cognitive dysfunction (POCD) is a postoperative memory or thinking impairment that has been corroborated by neuropsychological testing, for which increasing age is the leading risk factor. POCD is multifactorial in origin, but it remains unclear whether its occurrence is a result of surgery or general anesthesia. This article discusses the incidence, assessment, consequences, and prevention of POCD, as well as anesthetic strategies to improve cognitive outcome in elderly patients.
Ramaiah
Ramesh
R
Anesthesiology and Pain Medicine, University of Washington, Harborview Medical Center, Seattle, WA 98104-8009, USA. ramaiahr@u.washington.edu
Lam
Arthur M
AM
D000368:Aged; D000375:Aging / Q000523:psychology; D000765:Anesthesia, Conduction; D000768:Anesthesia, General; D019644:Arthroplasty, Replacement, Hip; D001921:Brain / Q000473:pathology; D003072:Cognition Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D003693:Delirium / Q000209:etiology; D006801:Humans; D008297:Male; D008606:Mental Processes; D010003:Osteoarthritis / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D012307:Risk Factors