Abstract

Due to change in demography, 33% of surgeries carried out are in geriatric patients, of which many develop POD and POCD with its major health care and public health consequences. This review will focus on functional connectivity in the brain, its pathophysiological changes with aging and anesthesia, and the consequent effects on brain function. Among the RSNs in the brain, DMN activity is significantly altered in in the aging brain and this correlates with the commonly observed mental function changes. Propofol and sevoflurane also affect DMN activity in young healthy subjects. While aging affects the anterior part of the DMN (frontal lobe regions), anesthesia affects activity in the posterior part (PCC, precuneus and, inferior parietal lobe). Understanding the effect of surgery and anesthesia on connectivity in elderly is essential in order to be able to optimize brain function after surgery.

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