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Postoperative Cognitive Dysfunction: Current Developments in Mechanism and Prevention

Wei Wang, Yan Wang, Haibo Wu, Liming Lei, Shiqin Xu, Xiaofeng Shen, Xirong Guo, Rong Shen, Xiaoqiong Xia, Yusheng Liu, Fuzhou Wang

Department of Anesthesiology, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China (mainland)

Med Sci Monit 2014; 20:1908-1912

DOI: 10.12659/MSM.892485

Available online:

Published: 2014-10-12

Abstract: Postoperative cognitive dysfunction (POCD) is a subtle disorder of thought processes, which may influence isolated domains of cognition and has a significant impact on patient health. The reported incidence of POCD varies enormously due to lack of formal criteria for the assessment and diagnosis of POCD. The significant risk factors of developing POCD mainly include larger and more invasive operations, duration of anesthesia, advanced age, history of alcohol abuse, use of anticholinergic medications, and other factors. The release of cytokines due to the systemic stress response caused by anesthesia and surgical procedures might induce the changes of brain function and be involved in the development of postoperative cognitive dysfunction. The strategies for management of POCD 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.

Keywords: Cognition Disorders - prevention & control, Incidence, Postoperative Complications, Risk Factors