ICU psychosis, or postoperative cognitive dysfunction, is not uncommon in older patients. Now the hunt is on for strategies to diminish the delirium, tweaking anesthesia protocols, preoperative care and even bringing in caregivers and family members to help. With the rising ranks of elderly living longer and heading for surgery, concern is mounting. “One of reasons this has come to forefront and has become a topic of increasing conversation is the fact that we are doing more surgery in older patients,” said Dr. Tom Porter, assistant professor of anesthesiology at UTMB. “It’s predicted that by the year 2020, the number of patients in the United States older than 65 is going to double. “Already more than half of all the patients that we operate on are over 65, so we anticipate that our exposure to patients in this elderly age group are going to increase,” said Porter, who started practice in 1981 when doctors often used the term sundowning for postoperative delirium. The exact cause is not known, but answers might lie in the neurotransmitters in the brain whose numbers decline with aging. Anesthesia might work by altering neurotransmitters, ushering in the unconsciousness needed for safe surgery. [Note: Paid subscription required. Contact Media Relations for more information.]