Dementia: Post-Surgery Cognitive Decline and the Microbiome
We continue in our quest to repair and enhance the all important communication between the gut and brain.
This time we examine what is termed Postoperative cognitive dysfunction (POCD) and how balancing the microbiome with probiotics can prevent neuroinflammation and create a more healthy equilibrium in the gut, and between the gut and brain.
POCD is a cognitive decline in the brain that happens after surgery, due to anesthesia. This damage or impairment can persist for weeks or even months (Sugita et al., 2023).
POCD does not just affect cognition, it also affects emotions, thinking, learning, and even your spirit (Xu et al., 2020).
This decline can also lead to long term dementia and other neurological issues (Alam et al., 2018).
Scientists contribute this post surgery dysfunction to neuroinflammation, and as we know, inflammation of any kind (micro or macro) leads to a host of chronic diseases (Calder et al., 2017).
In fact, this is what we call "inflammageing"- a concentration of inflammatory markers in the bloodstream that slowly ages different systems and organs in the body (clements & Carding, 2016).
Although cognitive decline post surgery is an inflammatory reaction - does it really start only after surgery?
Scientists are now looking into pre-surgery drugs, such as antibiotics, as well as other environmental and dietary factors that alter the microbiome before surgery which can be attributed to this cognitive decline post surgery (Xu et al., 2020).
And since the microbiome has been at the center of exploration in the hopes of calming down many different inflammatory markers (proinfalmmatory cytokines) and reducing oxidative stress, it is also now considered for POCD therapy (Sugita et al, 2023).
Sugita et al. summarize that indeed, probiotics, prebiotics, and synbiotics therapies can improve composition of gut microbiota and gut permeability, and therefore in general improve brain - gut axis, and in specific, improve post surgery induced inflammation (2023).
This article is lengthy and detailed. I was very pleased to see that the researchers included inflammageing and what goes on pre-surgery as our health does not just collapse for no reason and all of a sudden. A well done article that is worthy of our time. Article
Enjoy!
References
- Alam, A., Hana, Z., Jin, Z., Suen, K. C., & Ma, D. (2018). Surgery, neuroinflammation and cognitive impairment. EBioMedicine, 37, 547-556. Article
- Calder, P. C., Bosco, N., Bourdet-Sicard, R., Capuron, L., Delzenne, N., Doré, J., ... & Visioli, F. (2017). Health relevance of the modification of low grade inflammation in ageing (inflammageing) and the role of nutrition. Ageing research reviews, 40, 95-119. Article
- Clements, S. J., & Carding, S. R. (2016). Can Nutritional Intervention Counteract Immunosenescence in the Elderly?. In Molecular Basis of Nutrition and Aging (pp. 375-391). Abstract
- Sugita, S., Tahir, P., & Kinjo, S. (2023). The effects of microbiome-targeted therapy on cognitive impairment and postoperative cognitive dysfunction—A systematic review. Plos one, 18(2), e0281049. Article
- Xu, X., Hu, Y., Yan, E., Zhan, G., Liu, C., & Yang, C. (2020). Perioperative neurocognitive dysfunction: thinking from the gut?. Aging (Albany NY), 12(15), 15797. Article
Yours as Always,
Dohrea
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