COGNITIVE IMPAIRMENT IN POSTOPERATIVE CONDITIONS

Postoperative cognitive impairment (PCI), including postoperative cognitive dysfunction (POCD) and postoperative delirium (POD), remains one of the most significant neurological complications following surgical procedures, particularly among elderly and high-risk patients. Cognitive decline after surgery adversely affects memory, attention, executive function, learning ability, quality of life, and long-term functional independence. The increasing number of surgical interventions worldwide and the aging population have intensified the need for effective strategies to prevent, diagnose, and manage postoperative cognitive disorders. This review examines current evidence regarding the epidemiology, pathophysiological mechanisms, risk factors, diagnostic approaches, preventive measures, and therapeutic interventions associated with postoperative cognitive impairment. Particular attention is given to neuroinflammation, oxidative stress, blood-brain barrier dysfunction, cerebral hypoperfusion, anesthetic exposure, perioperative pain, and patient-related factors. Recent advances in biomarker research, neuroimaging, digital cognitive assessment, and artificial intelligence-based prediction models are also discussed. The findings indicate that postoperative cognitive impairment is a multifactorial condition requiring multidisciplinary perioperative management. Early identification of vulnerable patients, optimization of anesthesia and surgical techniques, implementation of enhanced recovery protocols, and postoperative cognitive rehabilitation may substantially reduce the incidence and severity of cognitive decline. Future investigations should focus on precision medicine approaches, molecular biomarkers, and personalized perioperative care to improve neurological outcomes after surgery.