title: Should general anaesthesia be avoided in the elderly?
abstract: Surgery and anaesthesia exert comparatively greater adverse effects on the elderly than on the younger brain, manifest by the higher prevalence of postoperative delirium and cognitive dysfunction. Postoperative delirium and cognitive dysfunction delay rehabilitation, and are associated with increases in morbidity and mortality among elderly surgical patients. We review the aetiology of postoperative delirium and cognitive dysfunction in the elderly with a particular focus on anaesthesia and sedation, discuss methods of diagnosing and monitoring postoperative cognitive decline, and describe the treatment strategies by which such decline may be prevented.
authors.affiliation: Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Strøm
authors.forename: L S
authors.initials: LS
authors.lastname: Rasmussen
authors.forename: F E
authors.initials: FE
authors.lastname: Sieber
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000009:adverse effects* / Q000379:methods; D003072:Cognition Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control; D003693:Delirium / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D011183:Postoperative Complications / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control; D012307:Risk Factors