Surgery and anaesthesia exert comparatively greater adverse effects on the elderly than on the younger brain, manifest by the higher prevalence of postoperative delirium and cognitive dysfunction. Postoperative delirium and cognitive dysfunction delay rehabilitation, and are associated with increases in morbidity and mortality among elderly surgical patients. We review the aetiology of postoperative delirium and cognitive dysfunction in the elderly with a particular focus on anaesthesia and sedation, discuss methods of diagnosing and monitoring postoperative cognitive decline, and describe the treatment strategies by which such decline may be prevented.
Anaesthesia (oxford), 2014, Vol 69 Suppl 1, p. 35-44
Aged; Aged, 80 and over; Anesthesia, General; Cognition Disorders; Delirium; Geriatric Assessment; Humans; Postoperative Complications; Risk Factors; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review