Aging and perioperative brain health: Mechanisms, management, and future.

Peilin CONG; Qian CHEN; Qianqian WU; Jing WANG; Xinwei HUANG; Qian ZHANG; Zheping CHEN; Huanghui WU; Yuxin ZHANG; Mengfan HE; Zhouxiang LI; Li TIAN; Lize XIONG

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Aging and perioperative brain health: Mechanisms, management, and future.

Author: Peilin CONG ¹ ; Qian CHEN ¹ ; Qianqian WU ¹ ; Jing WANG ² ; Xinwei HUANG ¹ ; Qian ZHANG ¹ ; Zheping CHEN ¹ ; Huanghui WU ¹ ; Yuxin ZHANG ¹ ; Mengfan HE ¹ ; Zhouxiang LI ¹ ; Li TIAN ¹ ; Lize XIONG ¹
Author Information

1. Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai 200434, China.
2. Department of Radiology, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai 200434, China.
Publication Type:Journal Article
Keywords: Aging; Anesthesia strategies; Neurobiological mechanisms; Perioperative brain health; Perioperative neurocognitive disorder
From: Chinese Medical Journal 2025;138(19):2381-2398
CountryChina
Language:English
Abstract: Globally, over 300 million surgeries are performed each year, and more than 50% of surgeries involve patients aged 65 and older. Aging poses significant challenges to perioperative brain health, as the deterioration of brain structure and function increases susceptibility to postoperative neurological complications. Protecting perioperative brain health remains a worldwide clinical challenge. With senescence, the brain undergoes a progressive decline in homeostasis across various molecular, cellular, and regional functions. Anesthetics and surgical stimuli may accelerate the disruption of brain homeostasis and exacerbate age-related neurodegeneration. This review provides a framework for understanding how anesthesia and surgery can affect brain health in the aging population and contribute to postoperative neurological complications, with a particular focus on perioperative neurocognitive disorder.