Objective:

This review aims to highlight the impacts of anesthesia in developing POCD

Background:

Postoperative cognitive dysfunction (POCD) is one of the most common postoperative complications, with a higher occurrence among the elderly. POCD is characterized by impaired memory, reduced attention deficit, and alteration in mood and personality changes. Its diagnosis is validated by conducting a baseline cognitive performance test preoperatively and compared with the mental status postoperatively.

Design/Methods:

Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines a systematic review was conducted on the anesthesiologicaleffects of POCD in the elderly. A PubMed search was performed with the keywords “Elderly”, “anesthesia”, and “postoperative cognitive dysfunction”. Four reviewers extracted the data independently and the risk of bias assessment was completed.

Results:

Of the 32 studies that were qualified, nineteen of them met the inclusion criteria and were finalized for review. The finalized studies concluded a 94% positive correlation between anesthesia and POCD and reported a wide range of cognitive function as early as six hours, seven days, and up to a year post-anesthesia. Some studies suggested the presence of other etiologies of POCD that were unmasked by anesthesia. These studies were well sampled from a similar demographic population regarding age, sex, cognitive function, and comorbidities.

Conclusions:

Despite the variation of type and route of administration of anesthetic, evidence from the analyzed studies highlights the increase in the incidence of POCD in the elderly who underwent anesthesia. Some factors contributing to the rise in the development of POCD include older age, pre-existing conditions, substance use, low literacy status, and coexistence of intra- and postoperative complications. Furthermore, the geriatric population has a higher probability of requiring surgical treatment and developing cognitive dysfunction, hence the need for more studies on this topic to better understand, prevent and manage these effects.