• Qianyu Cui, Dexiang Wang, Min Zeng, Jia Dong, Hailong Jin, Zhengfang Hu, Yuan Zhang, Yuming Peng, and Ruquan Han.
• Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
• BMJ Open. 2020 Jan 6; 10 (1): e034657.

IntroductionThe incidence of covert stroke and cognitive dysfunction has gradually increased due to an ageing population. Recently, a prospective cohort study reported perioperative covert stroke was associated with an increased risk of postoperative cognitive dysfunction (POCD) 1 year after non-cardiac surgery. However, the mechanism remains unclear.Methods And AnalysisThis is a prospective observational trial aiming to investigate the cumulative incidence of perioperative covert stroke and test the hypothesis that perioperative covert stroke associates with POCD in elderly patients undergoing non-cardiac and non-neurological surgery. Data on risk factors, brain MRI, cognitive function evaluation and serum immune-inflammatory cytokines will be collected and analysed.Ethics And DisseminationEthical approval has been granted by the Medical Ethics Committee of Beijing Tiantan Hospital, Capital Medical University (reference number: KY2017-027-02). The results of this study will be disseminated through presentations at scientific conferences and publication in scientific journals.Trial Registration NumberNCT03081429.© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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