Prevalence Of Postoperative Cognitive Dysfunction Research Articles

Cognitive dysfunction in older patients undergoing non-neurosurgery in the immediate postoperative period: A systematic review.

To explore the risk factors associated with postoperative cognitive dysfunction in older patients within the first 7 days after non-neurosurgical surgery and anaesthesia. A systematic review. Following, PRISMA 2020 (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Checklist, a systematic review of studies published from January 2018 to January 2024. The literature search was conducted across six electronic online databases, including PubMed, EMBASE, Scopus, Ovid, MEDLINE and Science Direct, and the Johns Hopkins Nursing Evidence-Based Practice Evidence Rating Scale was used for study appraisal. The initial search yielded 1750 studies. The review included 19 studies which comprised prospective observational, case-control and retrospective studies. The prevalence of postoperative cognitive dysfunction ranged from 19% to 64% among older adults undergoing non-neurosurgery. The identified risk factors were classified into three phases including preoperative, intraoperative and postoperative. Preoperative risk factors were found in age, educational attainment, malnutrition, preoperative biomarkers and co-morbidities. Intraoperative risk factors were the duration of the operation, blood loss during the operation and anaesthesia used. Postoperative risk factors consisted of postoperative biomarkers and postoperative pain. The result from this review may assist researchers and healthcare providers in assessing the underlying causes and risk factors of postoperative cognitive dysfunction, and in formulating suitable preventative and therapeutic strategies for older adults with non-neurosurgery during the short-term postoperative period.

Postoperative cognitive dysfunction-current research progress.

Postoperative cognitive dysfunction (POCD) commonly occurs after surgery, particularly in elderly individuals. It is characterized by a notable decline in cognitive performance, encompassing memory, attention, coordination, orientation, verbal fluency, and executive function. This reduction in cognitive abilities contributes to extended hospital stays and heightened mortality. The prevalence of POCD can reach 40% within 1 week following cardiovascular surgery and remains as high as 17% 3 months post-surgery. Furthermore, POCD exacerbates the long-term risk of Alzheimer's disease (AD). As a result, numerous studies have been conducted to investigate the molecular mechanisms underlying POCD and potential preventive strategies. This article provides a review of the research progress on POCD.

Postoperative Cognitive Dysfunction: Mechanism and Prevention

Postoperative cognitive dysfunction (POCD) refers to a condition characterized by impaired cognitive processing and reasoning, which can negatively affect perceptual abilities and play a crucial role in overall health. Factors such as age, educational attainment, history of mental illness, and the presence of comorbid diseases can influence the occurrence of postoperative cognitive dysfunction (POCD). Strategies aimed at preventing the occurrence of postoperative cognitive dysfunction (POCD) involve both surgical interventions and addressing patient-related issues, as well as optimizing the administration of anesthetics and conducting surgery in a stress-free manner. The benefits of reducing oxidative stress and inflammation in brain cells have been demonstrated. Postoperative recovery may be extended due to postoperative cognitive dysfunction (POCD). The studies conducted showed heterogeneity in terms of patient groups, methodology used to quantify POCD, and study design, making it challenging to draw generalizable conclusions. The prevalence of postoperative cognitive dysfunction (POCD) is a widespread health concern globally.

The involvement of the gut microbiota in postoperative cognitive dysfunction based on integrated metagenomic and metabolomics analysis.

As the population ages and medical technology advances, anesthesia procedures for elderly patients are becoming more common, leading to an increased prevalence of postoperative cognitive dysfunction. However, the etiology and correlation between the gut microbiota and cognitive dysfunction are poorly understood, and research in this area is limited. In this study, mice with postoperative cognitive dysfunction were found to have reduced levels of fatty acid production and anti-inflammatory flora in the gut, and Bacteroides was associated with increased depression, leading to cognitive dysfunction and depression. Furthermore, more specific microbial species were identified in the disease model, suggesting that modulation of host metabolism through gut microbes may be a potential avenue for preventing postoperative cognitive dysfunction.

Assessment of postoperative cognitive dysfunction and its impact on the quality of life among elderly patients. Running title- POCD and quality of life among elderly

Background: The ever-increasing fraction of older adults who requires operative care, needs not just longer life, but an active and good quality of life. The postoperative cognitive dysfunction (POCD) is well known complication of surgery and anaesthesia in elderly patient. Enhance recovery protocol helps in minimizing the stress response and in effect the onset of POCD. In current study, we made an attempt to reduce the prevalence of postoperative cognitive dysfunction in elderly patients by implementing enhanced recovery protocol, and evaluated the association with quality of life. Methods: The current study was observational, prospective study conducted on patients aged above 70 of years. Cognitive function was assessed with Trail making test (TMT), Stroop color word test (SCWT) and Visual verbal learning test (VVLT), at preoperatively (T0) and postoperatively at 24 hours (T24), 96 hours (T96) and 3 months (T3). Quality of life was assessed in patients using WHO quality of life BREF Questionnaire, which was done at T0 and T3. Results: Total forty-five patients were enrolled in the study, out of which 25 (55.5%) patients developed postoperative cognitive dysfunction (POCD) at T24 and T 96, while at T3, 14 (31.1%) had POCD. Major surgery was significantly associated with onset of POCD. Patients who developed POCD had significantly low quality of life, especially psychological component. Conclusions; The incidence of POCD was 31.1% at 3 months after using Enhanced recovery protocol, so it should be made mandatory especially for elderly patients as POCD leads to worsening in the quality of life.

Assessment of Postoperative Cognitive Dysfunction and its Impact on the Quality of Life among Elderly Patients.

Background: The ever-increasing fraction of older adults who requires operative care, needs not just longer life, but an active and good quality of life. The postoperative cognitive dysfunction (POCD) is well known complication of surgery and anaesthesia in elderly patient. Enhance recovery protocol helps in minimizing the stress response and in effect the onset of POCD. In current study, we made an attempt to reduce the prevalence of postoperative cognitive dysfunction in elderly patients by implementing enhanced recovery protocol and evaluated the association with quality of life. Methods: The current study was observational, prospective study conducted on patients aged above 70 of years. Cognitive function was assessed with Trail making test (TMT), Stroop colour word test (SCWT) and Visual verbal learning test (VVLT), at preoperatively (T0) and postoperatively at 24 hours (T24), 96 hours (T96) and 3 months (T3). Quality of life was assessed in patients using WHO quality of life BREF Questionnaire, which was done at T0 and T3. Results: Total fourty-five patients were enrolled in the study, out of which 25 (55.5%) patients developed postoperative cognitive dysfunction (POCD) at T24 and T 96, while at T3, 14 (31.1%) had POCD. Major surgery was significantly associated with onset of POCD. Patients who developed POCD had significantly low quality of life, especially psychological component. Conclusions: The incidence of POCD was 31.1% at 3 months after using Enhanced recovery protocol, so it should be made mandatory especially for elderly patients as POCD leads to worsening in the quality of life.

Effect of Preoperative Dexmedetomidine on Prevalence of Postoperative Cognitive Dysfunction in Elderly Patients Candidate for Orthopedic Surgery under General Anesthesia

Background: Postoperative cognitive dysfunction (POCD) is amongst the most critical complications after surgery. This study shows the effect of dexmedetomidine on the prevalence of postoperative cognitive impairment. Methods: In this double-blinded clinical trial study, patients aged 60-80 years undergoing pelvic and femoral orthopedic surgery were randomly assigned in one of the two groups of the course, i.e., Dexmedetomidine (DEX) or normal saline (NS). We infuse One hour before anesthesia, one µg/kg dexmedetomidine in the group (DEX), and the same volume of normal saline (NS). Mini-Mental State Examination test (MMSE) was applied to evaluate the patients' cognitive condition, One day before the surgery, 24 and 72 hours after the surgery. Results: There was no significant difference between the two groups in terms of age, sex, duration of anesthesia, duration of surgery, and the amount of bleeding during operation (P>0.0). The postoperative hematocrit level was lower than the preoperative level in the group (DEX) (P<0.05). There was no significant difference in MMSE test scores pre and postoperatively between the two groups (P>0.05). Conclusion: Dexmedetomidine infused before surgery has no preventive effect on POCD in elderly patients undergoing pelvic and femoral orthopedic surgery under general anesthesia.

Postoperative Delirium and Postoperative Cognitive Dysfunction: Overlap and Divergence.

Postoperative delirium and postoperative cognitive dysfunction share risk factors and may co-occur, but their relationship is not well established. The primary goals of this study were to describe the prevalence of postoperative cognitive dysfunction and to investigate its association with in-hospital delirium. The authors hypothesized that delirium would be a significant risk factor for postoperative cognitive dysfunction during follow-up. This study used data from an observational study of cognitive outcomes after major noncardiac surgery, the Successful Aging after Elective Surgery study. Postoperative delirium was evaluated each hospital day with confusion assessment method-based interviews supplemented by chart reviews. Postoperative cognitive dysfunction was determined using methods adapted from the International Study of Postoperative Cognitive Dysfunction. Associations between delirium and postoperative cognitive dysfunction were examined at 1, 2, and 6 months. One hundred thirty-four of 560 participants (24%) developed delirium during hospitalization. Slightly fewer than half (47%, 256 of 548) met the International Study of Postoperative Cognitive Dysfunction-defined threshold for postoperative cognitive dysfunction at 1 month, but this proportion decreased at 2 months (23%, 123 of 536) and 6 months (16%, 85 of 528). At each follow-up, the level of agreement between delirium and postoperative cognitive dysfunction was poor (kappa less than .08) and correlations were small (r less than .16). The relative risk of postoperative cognitive dysfunction was significantly elevated for patients with a history of postoperative delirium at 1 month (relative risk = 1.34; 95% CI, 1.07-1.67), but not 2 months (relative risk = 1.08; 95% CI, 0.72-1.64), or 6 months (relative risk = 1.21; 95% CI, 0.71-2.09). Delirium significantly increased the risk of postoperative cognitive dysfunction in the first postoperative month; this relationship did not hold in longer-term follow-up. At each evaluation, postoperative cognitive dysfunction was more common among patients without delirium. Postoperative delirium and postoperative cognitive dysfunction may be distinct manifestations of perioperative neurocognitive deficits.

Experimental insights into age‐exacerbated cognitive dysfunction after peripheral surgery

Here I comment on the recent contribution by Barrientos et al. J. Neurosci. 32, 14641-14648 (2012) addressing treatment possibilities for surgery-induced cognitive dysfunction. It has been over 15 years since the publication of a landmark study that indicated age as a major risk factor for postoperative cognitive dysfunction (POCD) (Moller et al., Lancet 351, 857-861 1998). With increasing life expectancy, surgical procedures conducted in elderly persons are becoming more common. The prevalence of POCD may mean that some patients will exchange the incapacitating condition that led them to surgery in the first instance for another such condition, which has been created by the surgical procedure itself. The report by Barrientos and collaborators (2012) is a timely and welcome study that further examines treatment possibilities for surgery-induced cognitive dysfunction. Future studies should address issues such as intensity and onset of inflammation within the brain and additional treatments possibilities beyond IL-1-ra.

Early Cognitive Functions in Patients after Embolization in Neuroradiological Suite – A Comparison of Two Anesthetic Techniques

Background: Less is known about prevalence of postoperative cognitive dysfunction after neurosurgical procedures. A Hindi version of Mini Mental State Examination (HMSE) is widely used for illiterate Hindi speaking population in the Indian subcontinent for assessment of cognitive dysfunction. The aim of the study was to assess effects of anesthetics on neurocognitive function in patients undergoing interventional procedure in neuroradiological suite. Methods: Twenty five patients with intracranial arterio-venous malformations and cerebral aneurysms were randomized to receive intravenous (propofol) or inhalational anesthetic (isoflurane). HMSE was performed in the ICU at 1 hour and 24 hours of tracheal extubation. Results: Baseline demographics like age and weight of patients differed significantly between the groups; however their cognitive functions were comparable. Intraoperative hemodynamic parameters like heart rate and mean arterial pressure were comparable between the two groups. Cognitive functions noted at the two time intervals in the postoperative period were also comparable between the two groups. Conclusion: We observed that anesthetic technique did not affect post embolization cognitive function, but, a better hemodynamic stability was maintained with total intravenous anesthesia.