title: Biomarkers of postoperative delirium and cognitive dysfunction.
abstract: Elderly surgical patients frequently experience postoperative delirium (POD) and the subsequent development of postoperative cognitive dysfunction (POCD). Clinical features include deterioration in cognition, disturbance in attention and reduced awareness of the environment and result in higher morbidity, mortality and greater utilization of social financial assistance. The aging Western societies can expect an increase in the incidence of POD and POCD. The underlying pathophysiological mechanisms have been studied on the molecular level albeit with unsatisfying small research efforts given their societal burden. Here, we review the known physiological and immunological changes and genetic risk factors, identify candidates for further studies and integrate the information into a draft network for exploration on a systems level. The pathogenesis of these postoperative cognitive impairments is multifactorial; application of integrated systems biology has the potential to reconstruct the underlying network of molecular mechanisms and help in the identification of prognostic and diagnostic biomarkers.
authors.affiliation: Bioinformatics core, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg Belvaux, Luxembourg.
authors.forename: Anna
authors.initials: A
authors.lastname: Fournier
authors.affiliation: Bioinformatics core, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg Belvaux, Luxembourg.
authors.forename: Roland
authors.initials: R
authors.lastname: Krause
authors.affiliation: Experimental and Clinical Research Center (ECRC), Department of Anesthesiology and Operative Intensive Care Medicine, Charité University Medicine Berlin Berlin, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Winterer
authors.affiliation: Bioinformatics core, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg Belvaux, Luxembourg.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Schneider
keywords: POCD; POD; biomarker; postoperative cognitive dysfunction; postoperative delirium; systems biology