Gut-brain axis and post-operative cognitive dysfunction: A multifactorial perspective on microbiota, inflammation, and cognitive health

Post-operative cognitive dysfunction (POCD) is a common but often overlooked issue, especially in older adults after surgery. This review looks into how the gut and brain are connected—a relationship known as the gut-brain axis—and how tiny microbes living in our gut might influence our brain health during recovery. The gut microbiota helps produce important substances like short-chain fatty acids and neurotransmitters that play a key role in memory, mood, and brain function. Among these microbes, Akkermansia muciniphila stands out for supporting the gut lining, reducing inflammation, and balancing chemicals that affect cognition. Surgery, anesthesia, and antibiotics can disturb this balance, leading to “gut dysbiosis”, which may trigger brain inflammation and worsen POCD. By reviewing 11 carefully selected studies, this paper explores how restoring gut health—using probiotics like Akkermansia muciniphila or combinations like VSL#3—could be a promising way to protect the brain after surgery. Overall, these findings highlight a powerful connection between gut health and brain recovery, suggesting that personalized probiotic treatments might one day help improve mental outcomes in surgical patients. More clinical studies are needed, but the potential here is both exciting and hopeful.