Post-operative cognitive disorders in the elderly

Two distinct categories: Postoperative cognitive disorders include delinum and longterm cognitive dysfunction. Delerium: Delirium is an acute state occurring early during the postoperati ve period. It may be considered as an acute cerebral insufficiency which ma y be consecutive both to die negative effects of aging and chronic illness on cognitive function, and to the cerebral impact of operative stress. in a ddition, precipitating postoperative medical factors may facilitate cerebra l failure. Only a few studies have been devoted to prevention programs aime d at reducing the risk of postoperative delirium. Nevertheless, we can hypo thesize that a preoperative gerontology assessment would be effective in de termining risk factors of delirium in old patients and thus enable proposin g individual postoperative management. Long-term cognitive dysfunction: The definition of this clinical picture is less precise than delinum. Long-term cognitive dysfunction corresponds to a loss oi cognitive performance in the weeks and months after anesthesia. T he IPOCD1 study conducted in a large cohort of elderly patients has shown t hat postoperative cognitive dysfunction was present in 25.8% oi patients 1 week alter surgery and in 9.9% 3 months after surgery. One to two years alt er surgery, cognitive dysfunction was observed in 10.4% oi patients compare d with 10.6% in a control population oi non-operated patients. We would sug gest that in many cases, postoperative cognitive disfunction may result fro m preoperative dementia unmasked by surgery.