A brief review of post-operative delirium and post-operative cognitive decline, the possibility that anaesthesia and surgery may contribute (though for which evidence is observational and low quality), and potential methods for detection, quantification and avoidance.

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• C Strøm, L S Rasmussen, and F E Sieber.
• Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
• Anaesthesia. 2014 Jan 1; 69 Suppl 1: 35-44.

AbstractSurgery 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. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

This article appears in the collection: Does anesthesia cause post-operative delirium and post-operative cognitive decline?.

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