Postoperative cognitive dysfunction in elderly patients. An integrated psychological and medical approach

The aim of the article is to review the latest progresses in the research of postoperative cognitive dysfunction (POCD) after cardiac and noncardiac surgery in elderly patients. While it is not yet possible to provide definite answers to some questions regarding POCD and additional work is required before a complete understanding of the mechanisms involved, we investigate the definition criteria for POCD, its incidence, medical complications and the social impact of POCD following anaesthesia and surgery. The article also reviews the POCD risk factors and the recent advances in identifying specific POCD biomarkers as well as the vulnerable cognitive areas of POCD and the neuropsychological instruments most frequently used to define and to survey the long-term follow-up of POCD.