[Postoperative cognitive dysfunction (POCD): strategy of prevention, assessment and management]

Ann Fr Anesth Reanim. 2011 Oct;30(10):e49-53. doi: 10.1016/j.annfar.2011.08.009. Epub 2011 Sep 25.
[Article in French]

Abstract

The femoral neck fracture is a major cause of morbidity and mortality in the elderly. The etiology of cognitive impairment observed in this population of aged patient seems to be multifactorial. In the strategy of prevention, elderly patient must have the clearer information dealing with the postoperative cognitive dysfunction. This would reduce the incidence of POCD and some cognitive complaints, which often reflect the anxiety of the elderly patient facing the possibility of cognitive impairment. During the anaesthesia consultation, it seems important to assess the cognitive function of this elderly patient (like using neuropsycholgical scale as the MMSE) and to identify associated risk factors of cognitive dysfunction. The management of cognitive disorders should be multidisciplinary, the anesthesiologist being the main referent, in collaboration with the geriatrician and the surgeon. In the clinical setting of femoral neck fracture in the elderly, this multimodal management (pain, nutrition, functional rehabilitation to make these patients autonomous as quickly as possible), seems to improve the functional prognosis and to have the observed POCD decreased.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Aged
  • Cognition Disorders / diagnosis
  • Cognition Disorders / epidemiology
  • Cognition Disorders / prevention & control*
  • Cognition Disorders / psychology*
  • Femoral Neck Fractures / complications
  • Femoral Neck Fractures / rehabilitation
  • Femoral Neck Fractures / surgery
  • Humans
  • Neuropsychological Tests
  • Patient Care Management
  • Postoperative Care
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control*
  • Postoperative Complications / psychology*
  • Preoperative Care