Perioperative neurocognitive disorder (PND) is a significant neurological complication in aging perioperative patients that impacts post-operative cognition. PND is currently diagnosed through cognitive function testing, which is limited by its subjectivity and time requirements. Thus, the identification of biomarkers to assess PND onset is a priority to identify at-risk individuals and enable interventions and treatments to patient outcomes. This article synthesizes expert perspectives on brain aging and PND, presents the latest clinical evidence on PND biomarkers (imaging, electroencephalography, and molecular biomarkers), and delves into the relationship between PND and other age-related cognitive disorders. Thorough review of PND research identified several biomarkers with high sensitivity and specificity, offering a solid scientific foundation to predict and diagnose PND. These biomarkers not only enhance diagnostic accuracy for clinicians but also provide opportunities for earlier intervention and more effective treatment, potentially enhancing patient outcomes and quality of life.
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http://dx.doi.org/10.1007/s11427-024-2797-x | DOI Listing |
J Inflamm Res
February 2025
Department of Anesthesiology, Anesthesiology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, 350005, People's Republic of China.
Background: Perioperative neurocognitive disorders (PND) are common in elderly patients after surgery, leading to long-term cognitive decline and reduced quality of life. The mechanisms are unclear, but ferroptosis, a key cell death pathway, may be involved in the disruption of brain homeostasis during perioperative stress.
Methods: In this study, we used the SAM-P8 mouse model to simulate brain aging and observe isoflurane-induced ferroptosis.
J Clin Anesth
March 2025
Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu, China. Electronic address:
Perioperative neurocognitive disorders (PND) refer to a constellation of symptoms that primarily affect the elderly and typically manifest as common complications after exposure to surgery and anesthesia. PND is associated with high morbidity, mortality, and progression to neurodegenerative diseases, thus exerting significant financial strains on families as well as the healthcare system. Given that an ageing global population is an inevitable trend and, with the latest advances in the healthcare system, an ever-growing number of elderly people present for surgery and anesthesia, PND is of prominent concern.
View Article and Find Full Text PDFInt J Surg
March 2025
Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China.
Introduction: With an estimated 2.1 million hip and knee replacements performed annually in developed countries, orthopaedic surgeries can result in complications such as postoperative pain and cognitive dysfunctions. Dexmedetomidine shows potential for reducing pain and opioid use and improving cognitive outcomes, but its efficacy in orthopaedic settings needs further evaluation.
View Article and Find Full Text PDFJ Anaesthesiol Clin Pharmacol
October 2024
Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Background And Aims: Delayed neurocognitive recovery (DNR) and postoperative neurocognitive disorder (P-NCD) are common postoperative complications affecting older patients. This review evaluates perioperative approaches for preventing DNR and P-NCD in older noncardiac surgical patients.
Material And Methods: We searched databases for relevant articles from inception through June 2022 and updated in May 2023 (PROSPERO ID CRD42022359289).
Brain Res Bull
February 2025
Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA. Electronic address:
Background: The brain requires a continuous fuel supply to support cognition and can get energy from glucose and ketones. Dysregulated brain metabolism is thought to contribute to perioperative neurocognitive disorders and anesthesia-induced burst suppression. Therefore, we investigated the relationship between brain metabolites and neurophysiology during the behavioral states of sleep and anesthesia under a standard diet (SD) or a ketogenic diet (KD).
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