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The relationship between postoperative cognitive dysfunction and cerebral small vessel disease: A comprehensive
Xuhua Xu1, Zhiya Chen2,3, Feng Gao4
1Department of Neurology, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, China.
Cerebral small vessel disease (CSVD) is linked to postoperative cognitive dysfunction (POCD) in older adults. Understanding this relationship aids in preventing and managing cognitive decline after surgery.
Area of Science:
- Neurology
- Geriatrics
- Pathology
Background:
- Postoperative cognitive dysfunction (POCD) is a frequent complication in elderly surgical patients.
- Cerebral small vessel disease (CSVD) is increasingly recognized as a significant risk factor for POCD.
Purpose of the Study:
- To review the epidemiological, pathophysiological, and clinical evidence linking CSVD and POCD.
- To explore the role of Alzheimer's disease (AD) pathology in the CSVD-POCD relationship.
Main Methods:
- Comprehensive literature search of major databases (2000-2023).
- Analysis of epidemiological, animal, neuroimaging, and clinical studies.
- Inclusion of reference list checking for thoroughness.
Main Results:
- CSVD and POCD share risk factors (age, comorbidities) and neuropathological changes (hypoperfusion, inflammation).
- CSVD, AD pathology, and POCD may have synergistic effects on cognitive decline.
- Preoperative CSVD burden and postoperative progression correlate with POCD development.
Conclusions:
- CSVD is a key factor in POCD development, especially with co-existing AD pathology.
- Perioperative management strategies for elderly patients must consider CSVD.
- Further understanding will guide evidence-based prevention and management of POCD.
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