Challenges in Surgical and Perioperative Care for Brazil's Aging Population

Brazilian Journal of Anesthesiology (English Edition), Journal Year: 2025, Volume and Issue: unknown, P. 844586 - 844586

Published: Jan. 1, 2025

Language: Английский

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Mechanisms of perioperative neuronal injury and the search for therapies

British Journal of Anaesthesia, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

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Postoperative Delirium is Associated with Accelerated Brain Aging

Published: Jan. 1, 2025

Language: Английский

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Brain Structural and Functional Changes Associated With Postoperative Neurocognitive Disorders: Research Update

Anesthesia & Analgesia, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 19, 2025

Postoperative neurocognitive disorders (PNDs) are frequent and serious perioperative complications in the elderly, associated with increased morbidity mortality, length of hospital stay, need for long-term care. At present, pathogenesis PND is not completely clear, there various risk factors including surgical trauma stress mediating systemic inflammation towards neuroinflammation development which causes brain structural functional changes namely PND. For elderly patients, neurological monitoring may provide insights into function status. Monitoring also help clinicians identify potential risks would ultimately allow timely effective intervention better safety prognosis patients. In this review, we summarize mechanisms PND, discuss preliminary evidence regarding application electroencephalography, near-infrared spectroscopy, magnetic resonance, positron emission tomography imaging central nervous system during postoperative period.

Language: Английский

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Preoperative cognitive training for the prevention of postoperative delirium and cognitive dysfunction: a systematic review and meta-analysis

Perioperative Medicine, Journal Year: 2024, Volume and Issue: 13(1)

Published: Nov. 30, 2024

Abstract Background Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) are associated with major morbidity mortality after surgery. This systematic review meta-analysis determined whether preoperative training could reduce POD POCD in patients undergoing elective Methods Eligible randomized controlled trials were identified from CENTRAL, MEDLINE, EMBASE, Scopus, Web of Science, CINAHL databases inception to April 30, 2024. Two independent reviewers extracted data on trial characteristics risk bias for each trial. We rated the quality reporting interventions using template intervention description replication (TIDieR) evaluated overall certainty (quality) evidence The Grading Recommendations, Assessment, Development Evaluation (GRADE) system. Random-effects models used summarize treatment effect training. Post hoc sequential analyses (TSA) performed differentiate between “no effect” “evidence no effect.” Results Seven (four high three unclear bias) involving 864 participants (mean or median age 66 73 years old) considered eligible subject meta-analysis. was fair moderate. Most prehabilitation programs home-based, unsupervised, computerized requiring 2.3–10 h over 1–4 weeks before Cognitive did not (risk ratio [RR] 0.82, 95% confidence interval [CI] 0.57–1.18; I 2 = 30%; low five trials) early surgery (RR 0.93, CI 0.58–1.49; 67%; very four compared usual care. Nonetheless, TSA suggested that sample sizes insufficient exclude effectiveness reducing POCD. participants’ compliance rate either reported mostly below 70%. Conclusions Current is determine beneficial Given well-established benefits long-term cognition elderly, design future should be adequately powered incorporated strategies improve patient compliance.

Language: Английский

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Reserve and resilience: the cumulative risk of surgery on cognition and neurodegeneration in older individuals

The Lancet Healthy Longevity, Journal Year: 2024, Volume and Issue: 5(9), P. 100634 - 100634

Published: Sept. 1, 2024

Language: Английский

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