Exploring the lung-brain axis in perioperative neurocognitive disorders: a potential therapeutic target - Molecular Psychiatry
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Last updated: April 16, 2026
Perioperative neurocognitive disorders (PND), encompassing postoperative delirium (POD) and postoperative cognitive dysfunction (POCD), represent significant and frequent complications in elderly surgical patients. These disorders impact cognitive function and can lead to prolonged hospital stays, increased healthcare costs, and reduced quality of life. Research aims to understand the underlying mechanisms, identify risk factors, and develop effective prevention and management strategies to improve patient outcomes.
- This article focuses on the prevalence, pathogenesis, risk factors, and management of perioperative neurocognitive disorders (PND) in elderly surgical patients. PND includes postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). These conditions are associated with increased morbidity, mortality, and longer hospital stays.
- Key risk factors identified include advanced age, pre-existing cognitive impairment, and the type and duration of surgery. Pathogenesis is complex, involving multifactorial influences such as inflammation, anesthesia, surgical stress, and underlying patient comorbidities.
- Management strategies involve identifying at-risk patients, optimizing preoperative health, intraoperative monitoring, and postoperative care focused on early detection and intervention for delirium. Non-pharmacological interventions are preferred for delirium management, while pharmacological options are considered cautiously.
- Future research directions include elucidating specific molecular pathways and developing targeted prophylactic and therapeutic interventions to mitigate the incidence and severity of PND.
