The potential mechanism of postoperative cognitive dysfunction in older people

Postoperative cognitive dysfunction (POCD) is a common disorder following surgery, which seriously threatens the quality of patients' life, especially the older people. Accumulating attention has been paid to POCD worldwide in pace with the popularization of anesthesia/surgery. The development...

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Published inExperimental gerontology Vol. 130; p. 110791
Main Authors Lin, Xianyi, Chen, Yeru, Zhang, Piao, Chen, Gang, Zhou, Youfa, Yu, Xin
Format Journal Article
LanguageEnglish
Published England Elsevier Inc 01.02.2020
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Abstract Postoperative cognitive dysfunction (POCD) is a common disorder following surgery, which seriously threatens the quality of patients' life, especially the older people. Accumulating attention has been paid to POCD worldwide in pace with the popularization of anesthesia/surgery. The development of medical humanities and rehabilitation medicine sets higher demands on accurate diagnosis and safe treatment system of POCD. Although the research on POCD is in full swing, underlying pathogenesis is still inconclusive due to these conflicting results and controversial evidence. Generally, POCD is closely related to neuropsychiatric diseases such as dementia, depression and Alzheimer's disease in molecular pathways. Researchers have come up with various hypotheses to reveal the mechanisms of POCD, including neuroinflammation, oxidative stress, autophagy disorder, impaired synaptic function, lacking neurotrophic support, etc. Recent work focused on molecular mechanism of POCD in older people has been thoroughly reviewed and summed up here, concerning the changes of peripheral circulation, pathological pathways of central nervous system (CNS), the microbiota-gut-brain axis and the related brain regions. Accordingly, this article provides a better perspective to understand the development situation of POCD in older people, which is conductive to uncover the pathological mechanism and exploit reasonable treatment strategy of POCD. •Postoperative cognitive dysfunction (POCD) is a common complication after surgery with a high prevalence in older people.•Peripheral changes such as inflammation and immune activation are related to POCD in older people.•Central response of glial cells, neurotoxic changes and neurotrophic feebleness are involved in POCD of older people.•The microbiota-gut-brain axis plays a role in the development of POCD in older people.•Brain regions such as hippocampus, prefrontal lobes and cingulate gyrus play important roles in POCD of older people.
AbstractList Postoperative cognitive dysfunction (POCD) is a common disorder following surgery, which seriously threatens the quality of patients' life, especially the older people. Accumulating attention has been paid to POCD worldwide in pace with the popularization of anesthesia/surgery. The development of medical humanities and rehabilitation medicine sets higher demands on accurate diagnosis and safe treatment system of POCD. Although the research on POCD is in full swing, underlying pathogenesis is still inconclusive due to these conflicting results and controversial evidence. Generally, POCD is closely related to neuropsychiatric diseases such as dementia, depression and Alzheimer's disease in molecular pathways. Researchers have come up with various hypotheses to reveal the mechanisms of POCD, including neuroinflammation, oxidative stress, autophagy disorder, impaired synaptic function, lacking neurotrophic support, etc. Recent work focused on molecular mechanism of POCD in older people has been thoroughly reviewed and summed up here, concerning the changes of peripheral circulation, pathological pathways of central nervous system (CNS), the microbiota-gut-brain axis and the related brain regions. Accordingly, this article provides a better perspective to understand the development situation of POCD in older people, which is conductive to uncover the pathological mechanism and exploit reasonable treatment strategy of POCD.Postoperative cognitive dysfunction (POCD) is a common disorder following surgery, which seriously threatens the quality of patients' life, especially the older people. Accumulating attention has been paid to POCD worldwide in pace with the popularization of anesthesia/surgery. The development of medical humanities and rehabilitation medicine sets higher demands on accurate diagnosis and safe treatment system of POCD. Although the research on POCD is in full swing, underlying pathogenesis is still inconclusive due to these conflicting results and controversial evidence. Generally, POCD is closely related to neuropsychiatric diseases such as dementia, depression and Alzheimer's disease in molecular pathways. Researchers have come up with various hypotheses to reveal the mechanisms of POCD, including neuroinflammation, oxidative stress, autophagy disorder, impaired synaptic function, lacking neurotrophic support, etc. Recent work focused on molecular mechanism of POCD in older people has been thoroughly reviewed and summed up here, concerning the changes of peripheral circulation, pathological pathways of central nervous system (CNS), the microbiota-gut-brain axis and the related brain regions. Accordingly, this article provides a better perspective to understand the development situation of POCD in older people, which is conductive to uncover the pathological mechanism and exploit reasonable treatment strategy of POCD.
Postoperative cognitive dysfunction (POCD) is a common disorder following surgery, which seriously threatens the quality of patients' life, especially the older people. Accumulating attention has been paid to POCD worldwide in pace with the popularization of anesthesia/surgery. The development of medical humanities and rehabilitation medicine sets higher demands on accurate diagnosis and safe treatment system of POCD. Although the research on POCD is in full swing, underlying pathogenesis is still inconclusive due to these conflicting results and controversial evidence. Generally, POCD is closely related to neuropsychiatric diseases such as dementia, depression and Alzheimer's disease in molecular pathways. Researchers have come up with various hypotheses to reveal the mechanisms of POCD, including neuroinflammation, oxidative stress, autophagy disorder, impaired synaptic function, lacking neurotrophic support, etc. Recent work focused on molecular mechanism of POCD in older people has been thoroughly reviewed and summed up here, concerning the changes of peripheral circulation, pathological pathways of central nervous system (CNS), the microbiota-gut-brain axis and the related brain regions. Accordingly, this article provides a better perspective to understand the development situation of POCD in older people, which is conductive to uncover the pathological mechanism and exploit reasonable treatment strategy of POCD.
Postoperative cognitive dysfunction (POCD) is a common disorder following surgery, which seriously threatens the quality of patients' life, especially the older people. Accumulating attention has been paid to POCD worldwide in pace with the popularization of anesthesia/surgery. The development of medical humanities and rehabilitation medicine sets higher demands on accurate diagnosis and safe treatment system of POCD. Although the research on POCD is in full swing, underlying pathogenesis is still inconclusive due to these conflicting results and controversial evidence. Generally, POCD is closely related to neuropsychiatric diseases such as dementia, depression and Alzheimer's disease in molecular pathways. Researchers have come up with various hypotheses to reveal the mechanisms of POCD, including neuroinflammation, oxidative stress, autophagy disorder, impaired synaptic function, lacking neurotrophic support, etc. Recent work focused on molecular mechanism of POCD in older people has been thoroughly reviewed and summed up here, concerning the changes of peripheral circulation, pathological pathways of central nervous system (CNS), the microbiota-gut-brain axis and the related brain regions. Accordingly, this article provides a better perspective to understand the development situation of POCD in older people, which is conductive to uncover the pathological mechanism and exploit reasonable treatment strategy of POCD. •Postoperative cognitive dysfunction (POCD) is a common complication after surgery with a high prevalence in older people.•Peripheral changes such as inflammation and immune activation are related to POCD in older people.•Central response of glial cells, neurotoxic changes and neurotrophic feebleness are involved in POCD of older people.•The microbiota-gut-brain axis plays a role in the development of POCD in older people.•Brain regions such as hippocampus, prefrontal lobes and cingulate gyrus play important roles in POCD of older people.
ArticleNumber 110791
Author Yu, Xin
Zhou, Youfa
Zhang, Piao
Lin, Xianyi
Chen, Yeru
Chen, Gang
Author_xml – sequence: 1
  givenname: Xianyi
  surname: Lin
  fullname: Lin, Xianyi
– sequence: 2
  givenname: Yeru
  surname: Chen
  fullname: Chen, Yeru
– sequence: 3
  givenname: Piao
  surname: Zhang
  fullname: Zhang, Piao
– sequence: 4
  givenname: Gang
  surname: Chen
  fullname: Chen, Gang
  email: chengang120@zju.edu.cn
– sequence: 5
  givenname: Youfa
  surname: Zhou
  fullname: Zhou, Youfa
– sequence: 6
  givenname: Xin
  surname: Yu
  fullname: Yu, Xin
BackLink https://www.ncbi.nlm.nih.gov/pubmed/31765741$$D View this record in MEDLINE/PubMed
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Keywords Neuroinflammation
Postoperative cognitive dysfunction
Peripheral circulatory system
Central nervous system
Language English
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Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.
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Snippet Postoperative cognitive dysfunction (POCD) is a common disorder following surgery, which seriously threatens the quality of patients' life, especially the...
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SubjectTerms Aged
Aged, 80 and over
Alzheimer Disease - complications
Central nervous system
Central Nervous System - pathology
Cognition - physiology
Humans
Inflammation - complications
Neuroinflammation
Peripheral circulatory system
Postoperative Cognitive Complications - etiology
Postoperative cognitive dysfunction
Title The potential mechanism of postoperative cognitive dysfunction in older people
URI https://dx.doi.org/10.1016/j.exger.2019.110791
https://www.ncbi.nlm.nih.gov/pubmed/31765741
https://www.proquest.com/docview/2318735231
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