Postoperative Cognitive Dysfunction: Toward the Alzheimer's Disease Pathomechanism Hypothesis

Issue title: Anesthetics and Alzheimer's Disease

Guest editors: Pravat K. Mandalx and Vincenzo Fodaley

Article type: Review Article

Authors: Bilotta, Federico^{a; *} | Doronzio, Andrea^a | Stazi, Elisabetta^a | Titi, Luca^a | Fodale, Vincenzo^b | Di Nino, Gianfranco^c | Rosa, Giovanni^a

Affiliations: [a] Department of Anesthesiology, Critical Care and Pain Medicine, Neuroanaesthesia and Neurocritical care, University of Rome “La Sapienza”, Rome, Italy | [b] Department of Neurosciences Psychiatric and Anesthesiological Sciences, University of Messina, Policlinico Universitario “G.Martino”, Messina, Italy | [c] Department of Surgical and Anesthesiological Sciences, University of Bologna. Bologna, Italy | [x] Neurospectroscopy and Neuroimaging Laboratory, National Brain Research Center, Manesar, Gurgaon, India | [y] Department of Neurosciences, Psychiatric and Anesthesiological Sciences, University of Messina, Policlinico G. Martino, Messina, Italy

Correspondence: [*] Correspondence to: Federico Bilotta, M.D., Ph.D., Department of Anesthesiology, Critical Care and Pain Medicine, "Sapienza" University Rome, Italy, and Professor of Clinical Anesthesiology at the Albert Einstein College of Medicine, The Bronx, New York, New York, USA, Viale Acherusio 16, Rome 00199, Italy. Tel./Fax: +39 06 8608273; E-mail: bilotta@tiscali.it.

Abstract: Alzheimer's disease (AD), a chronic and progressive deterioration of memory and other cognitive domains, is the most common form of dementia. Because of related health and social impact, there is growing interest in assessing potential relationship between anesthesia and the onset and progression of chronic neurodegenerative disorders, including AD. Currently, preclinical and clinical research is addressed to identify underlying pathomechanisms, patient risk factors, and the use of the least provocative drugs and techniques, to minimize the incidence of chronic neurodegenerative disorders. Preclinical studies are providing an increasing body of evidences on some of the mechanisms that link anesthetics to neuronal programmed cell death (apoptosis) and accumulation of misfolded proteins in the aging brain. Therefore, risk factors and pathomechanisms of chronic neurodegenerative disorders, including AD, and persistent postoperative-postanesthesia cognitive dysfunction may overlap.

Keywords: Alzheimer's disease, postanesthesia cognitive dysfunction, postoperative delirium

DOI: 10.3233/JAD-2010-100825

Journal: Journal of Alzheimer's Disease, vol. 22, no. s3, pp. S81-S89, 2010