{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:50:08Z","timestamp":1777636208981,"version":"3.51.4"},"reference-count":59,"publisher":"The Korean Society of Anesthesiologists","issue":"2","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2023R1A2C1006054"],"award-info":[{"award-number":["2023R1A2C1006054"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2022R1C1C1009 62212"],"award-info":[{"award-number":["2022R1C1C1009 62212"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["anesth-pain-med.org"],"crossmark-restriction":true},"short-container-title":["Anesth Pain Med"],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:p>Perioperative brain health, encompassing postoperative delirium (POD) and longer-lasting cognitive decline, has become a major priority for patient safety and quality of recovery in older surgical patients. The 2018 unified nomenclature introduced perioperative neurocognitive disorders as an umbrella term spanning pre-existing neurocognitive disorder, POD, delayed neurocognitive recovery, and postoperative neurocognitive disorder. The incidence of POD varies widely, reflecting differences in age, baseline cognition, surgical type, and ascertainment; however, its clinical footprint is consistently substantial, with increased mortality, longer hospitalization, and downstream cognitive deterioration. Electroencephalography (EEG)-guided anesthesia trials have yielded mixed results, favoring its integration with hemodynamic optimization and medication stewardship. Screening uptake remains &lt; 10% in many settings, limiting the ability to provide scalable and equitable brain care. Current prevention standards prioritize multicomponent, non-pharmacological bundles such as mobilization, reorientation\/cognitive stimulation, sleep promotion, sensory optimization, hydration, nutrition, oxygen delivery, and prompt management of precipitating factors. Nonetheless, translation to \u201cprecision prevention\u201d is constrained by three gaps: low implementation of recommended screening pathways, heterogeneity and limited transportability of prognostic models, and an under-operationalized vulnerability domain in which frailty and malnutrition lack standardized tools, cut-offs, and linked interventions. Biomarkers and perioperative physiology including EEG suppression patterns and individualized perfusion targets are biologically coherent adjuncts for risk refinement; however, current evidence supports their use as additive stratifiers within bundles rather than stand-alone gatekeepers. Next-generation perioperative brain health studies should standardize vulnerability phenotyping, integrate evidence-based selective monitoring and biomarker-informed refinement, and embed these elements into scalable workflows that convert guidelines into practical bedside actions.<\/jats:p>","DOI":"10.17085\/apm.25494","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T05:41:12Z","timestamp":1777441272000},"page":"171-180","update-policy":"https:\/\/doi.org\/10.17085\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative delirium: from bundles to precision 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