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Older Patients' Postoperative Neurocognitive Recovery: A Narrative Review.

Ulrica Nilsson1, Anahita Amirpour1, Maria Lampi1,2,3

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Summary

Perioperative neurocognitive disorders are common in older adults after surgery, impacting patients and families. This review explores advances in understanding, assessing, and managing these conditions to improve patient outcomes.

Keywords:
delayed neurocognitive recoverynext of kinpatient experiencespostoperative deliriumpostoperative neurocognitive decline

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Area of Science:

  • Gerontology
  • Neuroscience
  • Anesthesiology

Background:

  • Perioperative neurocognitive disorders (PNDs) like delirium and neurocognitive disorder are frequent complications in older surgical patients.
  • These conditions affect 10-60% of major surgery patients, increasing risks for long-term cognitive and emotional issues.
  • Current diagnostic tools are underutilized, leading to many undiagnosed cases.

Purpose of the Study:

  • To review recent advancements in perioperative neurocognitive recovery.
  • To focus on symptomatology, patient/family experiences, assessment, interventions, and ethical considerations of PNDs.

Main Methods:

  • This study is a narrative review of current literature on perioperative neurocognitive disorders.
  • It synthesizes information on assessment tools, patient-reported outcomes, and care strategies.

Main Results:

  • PNDs can cause lasting cognitive and emotional problems, distressing for patients and families.
  • Ethical dilemmas arise concerning patient autonomy and decision-making capacity.
  • Standardized patient information and effective interventions for neurocognitive recovery are lacking.

Conclusions:

  • There is a critical need for improved diagnosis, patient-centered information, and evidence-based interventions for PNDs.
  • Addressing the psychological and ethical impact on patients and families is essential.
  • Further research into promoting neurocognitive recovery is warranted.