Dr. Hofmeister draws attention to a recently published paper on the association between biomarkers (interleukin 6, S100β protein, cortisol, etc.) and POCD.
Although these approaches are very interesting from a scientific perspective, it is my view that none of the named markers is suitable for use as a clinical screening instrument. It would be welcome to have a pre-operative screening tool to identify patients with an increased risk for POCD. In the publications mentioned, pre-operative baseline levels were often not determined; thus, it has not yet been possible to define a critical threshold value. Due to significant inter- and intra-individual variations and the fact that a clearly defined quantitative relationship with regard to the results of cognitive function tests still needs to be established, these markers are not yet suitable for post-operative screening to monitor recovery.
The cited paper of Xie et al. highlights the significance of subclinical cognitive impairments along with the development of dementia and the incidence of POCD. In this paper the biomarkers are derived from CSF, limiting their use as a routine pre-operative screening tool.
Despite numerous very interesting approaches to studying POCD, our understanding of the condition remains poor. Especially for the development of potential therapeutic approaches further insights are needed.
PD Dr. med. Ingrid Rundshagen
Conflict of interest statement
PD Dr. Rundshagen has received fees for the preparation of scientific further education events from Abbott GmbH & Co. KG (now AbbVie Deutschland GmbH & Co. KG).
|1.||Rundshagen I: Postoperative cognitive dysfunction. Dtsch Arztebl Int 2014; 111: 119–25. VOLLTEXT|