Current Perspectives on Postoperative Cognitive Dysfunction in the Ageing Population.
Ageing
anaesthesia
frailty
geriatrics
postoperative cognitive dysfunction
postoperative delirium
Journal
Turkish journal of anaesthesiology and reanimation
ISSN: 2667-677X
Titre abrégé: Turk J Anaesthesiol Reanim
Pays: Turkey
ID NLM: 101680817
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
26
01
2019
accepted:
06
03
2019
entrez:
13
12
2019
pubmed:
13
12
2019
medline:
13
12
2019
Statut:
ppublish
Résumé
Postoperative cognitive dysfunction (POCD) is defined as a prolonged cognitive function impairment that occurs within weeks to months of a surgical procedure. It is especially prevalent in the elderly population, leading to increased morbidity and mortality. As anaesthetic and surgical care continues to improve and become increasingly safer, a significantly greater number of older patients have elective surgical procedures today, yet this comes with an increased POCD risk as they go through the perioperative phases. Although the pathophysiology behind the development of POCD is still under investigation, current causative mechanisms include the mode of anaesthesia administered, anaesthetic used, cerebral hypoperfusion, hyperventilation and neuroinflammation. These findings lend an insight into the importance of being cognisant of the higher likelihood of POCD in at-risk patients, including the elderly, and taking precautions to include preoperative and postoperative cognitive testing, careful monitoring during anaesthesia, blood pressure control and early treatment of postoperative complications as they arise. In this review, we provide an update on the current understanding of the pathophysiology leading to POCD, identifying risk factors, prevention and treatment strategies, with a specific focus on the elderly population.
Identifiants
pubmed: 31828240
doi: 10.5152/TJAR.2019.75299
pii: tard-47-6-439
pmc: PMC6886822
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
439-447Informations de copyright
© Copyright 2019 by Turkish Anaesthesiology and Intensive Care Society.
Déclaration de conflit d'intérêts
Conflict of Interest: The authors have no conflicts of interest to declare.
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