الفهرس 
? Incidence and Diagnosis of POCDOnly 14 pages are availabe for public view
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Abstract
ostoperative cognitive dysfunction (POCD) is a subtle disorder of thought processes, which may influence isolated domains of cognition such as verbal memory, visual memory, language comprehension, visuospatial abstraction, attention, or concentration.
It is to be distinguished from postoperative delirium, which tends to be a transient and fluctuating disturbance of consciousness that tends to occur shortly after surgery, whereas POCD is a more persistent problem of a change in cognitive performance as assessed by neuropsychological tests.
The extent of cognitive deterioration following surgery and anesthesia has a significant impact on patient health and is substantially associated with prolonged hospital recovery, greater morbidity, and delays in functional recovery. POCD affects variety of cognitive domains, such as memory, information processing, and executive function.
In the beginning, patients usually complain about deterioration of memory, and some patients even find it hard to work effectively.
In general, larger and more invasive operations such as abdominal, thoracic, and vascular surgery, present a greater risk than smaller, simpler procedures such as outpatient surgery.
Irrespective of the type of surgery, advanced age is a major risk factor of POCD. As the incidence of POCD at 3 months after surgery was 7% in patients aged 60–69 and 14% in those over 69 years old. Advanced age is characterized by impairments in the function of the many regulatory processes, including increased physical and mental frailty and decreased ability to cope with stresses such as anesthesia and surgery.
The type of anesthesia might not contribute to the development of POCD. A study comparing regional versus general anesthesia in patients over 60 years old who have had major non-cardiac surgery has, surprisingly, found that there was no significant difference in the incidence of POCD at 3 months after surgery between general and regional anesthesia.
The best treatment seems to be prevention. It is important to recognize and work on potential preoperative risk factors. It is also necessary to inform patients of the occurrence of POCD after risk of a perioperative complication. The POCD incidence data in younger populations is limited.