Postoperative cognitive dysfunction and Alzheimer disease.

Alzheimer disease (AD) is the most prevalent neurodegenerative disorder in elderly people. Patients with AD appear to be particularly at risk for cognitive deterioration following anesthesia. Some in vitro studies suggest that exposure to general anesthesia (GA) promotes the AD process. On the other hand, there are no clinical studies that clearly demonstrate that GA is a cause of cognitive dysfunction in patients with probable AD. The aim of this research was to discuss the relation between postoperative cognitive dysfunction (POCD) and AD according to the literature. In vivo studies examining AD biomarkers postoperatively and in vitro studies exploring amyloid-β (Aβ) converge to indicate that anesthetics could affect AD pathogenesis, either directly or indirectly. Careful evaluation of the mental state should be mandatory for all elderly patients undergoing GA. Long-term prospective, randomized clinical studies are required to examine the relationship between POCD and AD.