Postoperative Cognitive Dysfunction

By Madison Gesualdo

Postoperative cognitive dysfunction (POCD) refers to a decline in neurocognitive function from a patient’s baseline functioning that occurs in individuals who undergo surgical processes and are put under anesthesia. Postoperative cognitive dysfunction complicates a patient’s central nervous system, delaying their neurocognitive recovery process as a whole. Individuals who endure POCD typically experience issues with their attention span, memory, learning, perception, executive functioning, and motor skills. POCD is not to be confused with postoperative delirium; while postoperative delirium is an acute state of neurocognitive functioning lasting approximately 1-3 days post-surgery, POCD typically persists longer, lasting weeks, months, or in some cases, years.

While POCD is not yet a formal psychiatric diagnosis, it is characterized by the DSM-5 as a mild neurological disorder, falling under the cognitive impairment classification. POCD occurs in roughly 10-54% of patients within the first few weeks of surgery.

A variety of risk factors for POCD have been identified, including advanced age, severity of the surgery being performed, type and amount of anesthesia being used, electrolyte imbalance, and pre-existing conditions (such as dementia and diabetes). These factors are examples of factors that would put a patient at higher risk for suffering from POCD after his or her surgery.

Although no specific treatment exists for postoperative cognitive dysfunction, different treatment methods have proven to reduce the effects of the condition. These methods include, but are not limited to:

• Anti-inflammatory drugs
• Biologically active substances
• Surgical techniques and anesthesia best suited to fit the specific patient being operated on
• Improving a person’s cognitive functioning prior to surgery

If you or someone you know is struggling with mental health issues, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychiatric Services. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/

References:

Brodier, E. A., & Cibelli, M. (2021). Postoperative cognitive dysfunction in clinical practice. BJA Education, 21(2), 75–82. https://doi.org/10.1016/j.bjae.2020.10.004

Spriano, P. (2024, September 9). What do we know about postoperative cognitive dysfunction? Medscape Medical News. https://www.medscape.com/viewarticle/what-do-we-know-about-postoperative-cognitive-dysfunction-2024a1000g9b?ecd=WNL_trdalrt_pos1_240909_etid6816496&uac=445328CY&impID=6816496

Zhao, Q., Wan, H., Pan, H., & Xu, Y. (2024). Postoperative cognitive dysfunction-current research progress. Frontiers in Behavioral Neuroscience, 18, 1328790. https://doi.org/10.3389/fnbeh.2024.1328790