Post-op cognitive decline and dementia: what’s the story?


Postoperative cognitive decline (POCD) is a worry – and older patients are recognised to be at increased risk. The underlying mechanism and the specific contribution of anaesthesia remains unclear.

Further study is ongoing to establish the extent of POCD, why it occurs and what we can do to prevent it.


“Current data do not support significant changes in practice other than avoiding purely elective procedures” ( ).


Early studies in mice indicated that it was surgery, rather than anaesthesia that had a greater impact on a dementia-vulnerable brain. How this translates to humans (with or without dementia) is not yet known.

It is unlikely that anaesthesia is an independent risk factor for the development of dementia ( ).

Meanwhile, the results of ongoing research in the areas of prevention and treatment of POCD are eagerly awaited by a growing sector or older patients in our community and the surgeons and anaesthetists who care for them…