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Postoperative delirium in the elderly: the potential neuropathogenesis

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Abstract

Postoperative delirium (POD) is a neurobehavioral syndrome caused by dysfunction of neural activity mainly in elderly people. POD is not uncommon, but under-recognized, and often serious. Multifactorial causes including aging, acetylcholine deficiency, sleep deprivation and intraoperative hypoxia have been proposed attempting to explain the processes leading to the development of POD. To date, however, no specific pathophysiologic mechanism has been identified. Here, we summarize the five most prominent theories (neuronal aging, neuroinflammation, neurotransmitter imbalance, neuroendocrine activation, and network connectivity change) to explain the development of delirium. Understanding of the neuropathogenesis of delirium will help focus future research, and assist in developing prophylactic and treatment strategies.

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Acknowledgements

This research was supported by the National Natural Science Foundation of China (81671045).

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  1. Department of Anesthesiology, The Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai Medical College of Fudan University, 83 Fenyang Road, 200031, Shanghai, China

    Yiru Wang & Xia Shen

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  1. Yiru Wang
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Wang, Y., Shen, X. Postoperative delirium in the elderly: the potential neuropathogenesis. Aging Clin Exp Res 30, 1287–1295 (2018). https://doi.org/10.1007/s40520-018-1008-8

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