The topic of perioperative brain health in the elderly continues to generate interest among both basic and clinical scientists, as reflected by funded grants and by contributions to the literature. Currently, there are more than 30 funded NIH grants dealing with postoperative cognitive dysfunction (POCD), including postoperative delirium (POD), and over 400 publications in 2017 alone in the same topic area. In addition to steady progress in preclinical mechanistic research, considerable progress has been made in patient-oriented research, including a few randomized controlled trials. We will attempt to succinctly summarize some of the major advances here, but we have to emphasize at the outset that firm conclusions on any of the major questions are not yet possible.

First and foremost, the field formerly known as “POCD” has suffered from enormous heterogeneity of definitions, tests, timing, magnitude, symptoms and duration...

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