Postoperative Cognitive Dysfunction: Preclinical Highlights and Perspectives on Preventive Strategies

Abstract

One of the common complications associated with anaesthesia and surgery in geriatric patients is the postoperative cognitive dysfunction (POCD). This cognitive impairment afects the long-term prognosis and has been shown to be associated with long-term disability, higher health care costs, and even increased mortality. On the other hand, clinical research on POCD is in its infancy, the condition has not been clariied, and since no strategy for management is currently available, it is imperative to develop speciic methods for prevention and management. Although its pathogenesis involves various factors, accumulating evidence suggests that surgery elicits an inlammatory response in the hippocampus, a brain area closely related to cognitive function, playing a key role in the development of POCD. Several studies suggest that age-related phenotypic change of microglia is associated with pathogenic neuroinlammation, and more importantly it may be modiiable. In this chapter, we discuss the current overview and preclinical highlights regarding POCD. We further discuss some perspectives on preventive strategies for POCD, based on the indings of our preclinical research and the available literature.