Cognitive Change Associated with Anesthesia and Surgery: An Introduction to POCD for Neuroscientists

Postoperative cognitive dysfunction (POCD) is a central nervous system (CNS) complication seen in elderly patients, characterized by a decline in memory, comprehension, and attention in patients after surgery and general anesthesia. The pathophysiologic mechanisms of postoperative cognitive dysfunction are not well understood and effective means of prevention and treatment are currently lacking. Basic and clinical research, including the use of pre-clinical animal models of POCD, is advancing rapidly. In this paper, we review and summarize various factors that contribute to the development of POCD, including oxidative stress, autophagy, impaired synaptic function, and neuroinflammation, and describe the construction of animal models of POCD. By analyzing the gap between clinical and basic research, we propose recommendations for clinically relevant animal model development and the conducting of clinical studies to better understand the mechanisms and etiology associated with POCD. We aim to enhance understanding of the occurrence of POCD and to provide a more comprehensive perspective on the prevention and treatment of POCD.