{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T06:09:40Z","timestamp":1778479780291,"version":"3.51.4"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Perioperative neurocognitive disorders (PNDs) are common and clinically significant complications in older surgical patients. Dexmedetomidine (DEX) has been investigated for neuroprotection; however, reported outcomes across PNDs subtypes remain inconsistent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA-ScR guidelines, we systematically searched PubMed, Embase, and Cochrane Library up to December 9, 2025. Eligible studies included patients aged \u2265 60\u202fyears undergoing non-cardiac surgery who received perioperative DEX. Data on study design, intervention characteristics, and cognitive outcomes were extracted and thematically synthesized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-seven studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f9,890 patients) were included. DEX effects varied by PNDs subtype and assessment timing. For delayed neurocognitive recovery (dNCR), 13 of 19 studies demonstrated improved cognitive performance or reduced incidence. For postoperative delirium (POD), results were heterogeneous: 6 trials reported significant incidence reduction, whereas 4 found no effect. None of the four studies assessing long-term postoperative neurocognitive disorder (pNCD) showed benefit. Proposed mechanisms include anti-inflammatory, antisympathetic, analgesic, and neuroprotective pathways. Substantial heterogeneity was observed in DEX protocols, cognitive tools, diagnostic criteria, and application of the updated nomenclature.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DEX most consistently benefits dNCR, supporting its use in acute postoperative recovery. Its effect on POD is context-dependent, and no protective effect against long-term pNCD is evident. Considerable methodological diversity underscores the need for standardized diagnostic approaches and rigorously designed large-scale trials to clarify DEX\u2019s role in perioperative cognitive protection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnins.2026.1824272","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T05:31:18Z","timestamp":1778477478000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of dexmedetomidine on perioperative neurocognitive disorders in elderly patients undergoing non-cardiac surgery: a scoping review"],"prefix":"10.3389","volume":"20","author":[{"given":"Jinxiang","family":"Xie","sequence":"first","affiliation":[{"name":"The First School of Clinical Medicine, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bokang","family":"Yang","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiayi","family":"Xie","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulrahman Khaled","family":"Alwesabi","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengying","family":"Ji","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhaohui","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Surgery, First Hospital of Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boxiong","family":"Gao","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qijing","family":"Liu","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine, Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yatao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Surgery, First Hospital of Lanzhou University","place":["Lanzhou, Gansu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.70163","article-title":"Dose-dependent relationship between intra-operative dexmedetomidine and delirium after non-cardiac surgery: a retrospective cohort study","author":"Ahrens","year":"2026","journal-title":"Anaesthesia"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"167","DOI":"10.32604\/oncologie.2020.012495","article-title":"Effects of ulinastatin combined with dexmedetomidine on postoperative cognitive function and central nerve specific protein level in elderly colorectal cancer patients after laparoscopic","volume":"22","author":"Bao","year":"2020","journal-title":"Oncologie"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1016\/j.bja.2025.05.035","article-title":"Effects of ketamine on postoperative cognition: a scoping review","volume":"135","author":"Brenna","year":"2025","journal-title":"Br. 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