【Abstract】Background With the advent of an aging society, postoperative cognitive dysfunction (POCD) attract more and more attention of clinicians. At the same time, emerging literature recognize that postoperative cognitive improvement (POCI) is possible. Objective To explore the risk factors of POCD and discuss the research progress of POCI. Content Reviewed mainly from four aspects: the existence of POCI, the brain plasticity and POCI, the regulation of the risk factors of POCD and the interventions conducive to POCI Trend How to control the risk factors of POCD, so that the elderly patients improve their health and quality of life through surgery and simultaneously experience POCI will become the directions of future.