Postoperative Cognitive Dysfunction: Knowns and Unknowns

Abstract

Aim of review: The aim of this review was to summarize and discuss current status and challenges in our understanding of the diagnosis, risk factors, pathophysiologic mechanisms, and preventions for postoperative cognitive dysfunction (POCD).Method: We searched and reviewed the articles about POCD published in the past 2 decades using PubMed and Google Scholar.Recent findings: POCD affects a wide variety of cognitive domains, including attention, memory, executive function and speed of information processing, with the deficits in memory and a reduced ability to handle intellectual challenges being most obvious. The causes of POCD are thought to be multifactorial and may include the preoperative health status of the patient, the patients' preoperative level of cognition, perioperative events related to the surgery itself, and possible neurotoxic effects of anesthetic agents. There are many controversies about POCD, from how it is measured to how long it lasts, to its precise implications for patients, and whether POCD is linked to a long-term risk of developing dementia.Summary: POCD is a topic of special importance in the geriatric surgical population. Unfortunately, no therapeutic interventions are available to prevent the onset of POCD, strategies for management of these patients should be a multimodal approach involving close cooperation between the anesthesiologist, surgeon, geriatricians, and family members to promote early rehabilitation and avoid loss of independence in these patients. Future researches focusing on the mechanisms involved in POCD are critical for better understanding and management of this cognitive dysfunction after surgery. Citation: Mu-Huo Ji, Fan Su, Jian-Jun Yang. Postoperative cognitive dysfunction: knowns and unknowns. J Anesth Perioper Med 2017; 4: 95-100. doi:10.24015/JAPM.2017.0018This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.