Rev Epidemiol Sante
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Rev Epidemiol Sante · Oct 2000
Review[Anesthesia and postoperative cognitive dysfunction in the elderly: a review of clinical and epidemiological observations].
Amnesic effects of anesthesia were first reported two hundred years ago, but the term postoperative cognitive dysfunction (POCD) has appeared only recently, covering a larger range of neuropsychological modifications resulting from surgical intervention. The clinical description of POCD is highly variable, ranging from concentration impairment to delirium. Significant short-term POCD is common in elderly persons, and can persist several months, varying both in time and intensity and affecting the full-range of cognitive functions (visual and auditory attention, primary and secondary memory, implicit memory, and visuospatial functioning). ⋯ We review the definition, epidemiology, etiology, pathophysiology and the clinical and public health implications of POCD. The effects of anesthetics are described in relation to ageing-related physiological changes. It is concluded that the complex interaction of etiological factors makes it difficult to determine at this point of time to what extent POCD may be attributed specifically to anesthetic agents.