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Cerebral Hypoxia: Its Role in Age-Related Chronic and Acute Cognitive Dysfunction. 2021

Brina Snyder, and Stephanie M Simone, and Tania Giovannetti, and Thomas F Floyd
From the Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas.

Postoperative cognitive dysfunction (POCD) has been reported with widely varying frequency but appears to be strongly associated with aging. Outside of the surgical arena, chronic and acute cerebral hypoxia may exist as a result of respiratory, cardiovascular, or anemic conditions. Hypoxia has been extensively implicated in cognitive impairment. Furthermore, disease states associated with hypoxia both accompany and progress with aging. Perioperative cerebral hypoxia is likely underdiagnosed, and its contribution to POCD is underappreciated. Herein, we discuss the various disease processes and forms in which hypoxia may contribute to POCD. Furthermore, we outline hypoxia-related mechanisms, such as hypoxia-inducible factor activation, cerebral ischemia, cerebrovascular reserve, excitotoxicity, and neuroinflammation, which may contribute to cognitive impairment and how these mechanisms interact with aging. Finally, we discuss opportunities to prevent and manage POCD related to hypoxia.

UI MeSH Term Description Entries
D002534 Hypoxia, Brain A reduction in brain oxygen supply due to ANOXEMIA (a reduced amount of oxygen being carried in the blood by HEMOGLOBIN), or to a restriction of the blood supply to the brain, or both. Severe hypoxia is referred to as anoxia and is a relatively common cause of injury to the central nervous system. Prolonged brain anoxia may lead to BRAIN DEATH or a PERSISTENT VEGETATIVE STATE. Histologically, this condition is characterized by neuronal loss which is most prominent in the HIPPOCAMPUS; GLOBUS PALLIDUS; CEREBELLUM; and inferior olives. Anoxia, Brain,Anoxic Encephalopathy,Brain Hypoxia,Cerebral Anoxia,Encephalopathy, Hypoxic,Hypoxic Encephalopathy,Anoxia, Cerebral,Anoxic Brain Damage,Brain Anoxia,Cerebral Hypoxia,Hypoxia, Cerebral,Hypoxic Brain Damage,Anoxic Encephalopathies,Brain Damage, Anoxic,Brain Damage, Hypoxic,Damage, Anoxic Brain,Damage, Hypoxic Brain,Encephalopathies, Anoxic,Encephalopathies, Hypoxic,Encephalopathy, Anoxic,Hypoxic Encephalopathies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000079690 Postoperative Cognitive Complications COGNITIVE IMPAIRMENT or functional decline after a surgical procedure. Postoperative Cognitive Decline,Postoperative Cognitive Disorders,Postoperative Cognitive Dysfunction,Postoperative Dementia,Cognitive Complication, Postoperative,Cognitive Decline, Postoperative,Cognitive Disorder, Postoperative,Cognitive Dysfunction, Postoperative,Complication, Postoperative Cognitive,Decline, Postoperative Cognitive,Dementia, Postoperative,Dementias, Postoperative,Disorder, Postoperative Cognitive,Dysfunction, Postoperative Cognitive,Postoperative Cognitive Complication,Postoperative Cognitive Disorder,Postoperative Dementias
D000375 Aging The gradual irreversible changes in structure and function of an organism that occur as a result of the passage of time. Senescence,Aging, Biological,Biological Aging
D060825 Cognitive Dysfunction Diminished or impaired mental and/or intellectual function. Cognitive Disorder,Mild Cognitive Impairment,Cognitive Decline,Cognitive Impairments,Mental Deterioration,Cognitive Declines,Cognitive Disorders,Cognitive Dysfunctions,Cognitive Impairment,Cognitive Impairment, Mild,Cognitive Impairments, Mild,Decline, Cognitive,Declines, Cognitive,Deterioration, Mental,Deteriorations, Mental,Disorder, Cognitive,Disorders, Cognitive,Dysfunction, Cognitive,Dysfunctions, Cognitive,Impairment, Cognitive,Impairment, Mild Cognitive,Impairments, Cognitive,Impairments, Mild Cognitive,Mental Deteriorations,Mild Cognitive Impairments
D019990 Perioperative Care Interventions to provide care prior to, during, and immediately after surgery. Care, Perioperative

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