Advances in research on the pathogenesis and signaling pathways associated with postoperative delirium (Review).
Molecular medicine reports August 1, 2025 Weiqing Li, Qin Shi, Ronghua Bai et al. 11 citations
Postoperative delirium (POD) is a common complication after surgery, marked by acute, fluctuating changes in consciousness and attention, with incidence rising with age. It is linked to longer hospital stays, higher costs, and increased morbidity and mortality, and may signal long-term cognitive decline. The underlying mechanisms are not fully understood but likely involve neuroinflammation, oxidative stress, neurotransmitter imbalances, and protein changes like β-amyloid deposition and tau hyperphosphorylation. Disruptions in sleep, brain activity, and gut-brain or olfactory-brain axes, along with genetic factors, may also contribute. Multiple signaling pathways, including Wnt/β-catenin and PI3K/AKT, are implicated. Prevention and treatment prioritize non-pharmacological strategies like cognitive training and the Hospital Elder Life Program, with pharmacological options such as dexmedetomidine and melatonin, and anesthesia management also playing a role.