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Does Anesthesia Cause Dementia or Memory Loss in the Elderly?

Posted Jun 02 2013 11:04am
Does anesthesia increase the odds of developing dementia later in life? Does anesthesia hasten memory loss in persons already living with Alzheimer's and dementia?

By Bob DeMarco
+Alzheimer's Reading Room  


Does Anesthesia Cause Dementia or Memory Loss in the Elderly?

Exposure to general anaesthesia increases the risk of dementia in the elderly by 35% according to a new study presented at Euroanaesthesia, the annual congress of the European Society of Anaesthesiology (ESA).

The research was conducted Dr Francois Sztark, INSERM and University of Bordeaux, France, and colleagues.

In a previous study Mayo clinic researchers concluded that elderly patients who receive anesthesia are no more likely to develop long-term dementia or Alzheimer’s disease than other seniors.

The senior author of the Mayo report was David Warner at the Mayo Clinic Children’s Center.

Yes, No, Maybe?

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There are a few issue here so lets try and untangle them.

The research we are referencing here in this article has to do with a single issue -

Does anesthesia increase the odds of developing dementia later in life.

The research at INSERM and University of Bordeaux and indicates that it can.

Here is the Gist of this INSERM research.
Exposure to general anaesthesia could increase the risk of dementia in elderly by 35 percent

Exposure to general anaesthesia increases the risk of dementia in the elderly by 35%, says new research presented at Euroanaesthesia, the annual congress of the European Society of Anaesthesiology (ESA). The research is by Dr Francois Sztark, INSERM and University of Bordeaux, France, and colleagues.

Postoperative cognitive dysfunction, or POCD, could be associated with dementia several years later. POCD is a common complication in elderly patients after major surgery. It has been proposed that there is an association between POCD and the development of dementia due to a common pathological mechanism through the amyloid β peptide. Several experimental studies suggest that some anaesthetics could promote inflammation of neural tissues leading to POCD and/or Alzheimer's disease (AD) precursors including β-amyloid plaques and neurofibrillary tangles. But it remains uncertain whether POCD can be a precursor of dementia.

In this new study, the researchers analysed the risk of dementia associated with anaesthesia within a prospective population-based cohort of elderly patients (aged 65 years and over). The team used data from the Three-City study, designed to assess the risk of dementia and cognitive decline due to vascular risk factors. Between 1999 and 2001, the 3C study included 9294 community-dwelling French people aged 65 years and over in three French cities (Bordeaux, Dijon and Montpellier).

Participants aged 65 years and over were interviewed at baseline and subsequently 2, 4, 7 and 10 years after. Each examination included a complete cognitive evaluation with systematic screening of dementia. From the 2-year follow-up, 7008 non-demented participants were asked at each follow-up whether they have had a history of anaesthesia (general anaesthesia (GA) or local/locoregional anaesthesia (LRA)) since the last follow-up. The data were adjusted to take account of potential confounders such as socioeconomic status and comorbidities.

The mean age of participants was 75 years and 62% were women. At the 2-year follow-up, 33% of the participants (n=2309) reported an anaesthesia over the 2 previous years, with 19% (n=1333) reporting a GA and 14% (n=948) a LRA. A total of 632 (9%) participants developed dementia over the 8 subsequent years of follow-up, among them 284 probable AD and 228 possible AD, and the remaining 120 non-Alzheimer's dementia. The researchers found that demented patients were more likely to have received anaesthesia (37%) than non-demented patients (32%). This difference in anaesthesia was due to difference in numbers receiving general anaesthetics, with 22% of demented patients reporting a GA compared with 19% of non-demented patients. After adjustment, participants with at least one GA over the follow-up had a 35% increased risk of developing a dementia compared with participants without anaesthesia.

Dr Sztark concludes: "These results are in favour of an increased risk for dementia several years after general anaesthesia. Recognition of POCD is essential in the perioperative management of elderly patients. A long-term follow-up of these patients should be planned."
We already wrote about the Mayo clinic study so you can read the Gist of those finding here -- No Link Between Anesthesia, Dementia in Elderly .

There is a second issue that can cause confusion. The issue

Does anesthesia hasten memory loss in person already living with Alzheimer's and dementia?
We have a long list of articles on this issue. Here are a few.
    Study Links Surgery and Anesthesia With Alzheimer’s

    "Although not definitive, this human biomarker study gives some credibility to the notion that anesthesia and surgery produce an inflammatory insult on the brain and accelerate chronic neurodegenerative diseases like Alzheimer's," Eckenhoff added. Alzheimer's and Anesthesia

    Alzheimer's and anesthesia don't mix well. Some physicians are advising their patients that are already diagnosed with Alzheimer’s to avoid surgery unless absolutely necessary. Dementia and Memory Loss Caused by Infection

    Undetected infections are common in dementia patients. These infections can lead to permanent memory loss, hard to deal with behavior, dullness (the not there effect), and even death.
You can also search the ARR Knowledge Base for additional information on these issues. The search box is on the right hand side of every webpage here.

_________________________________________________Related Content
Bob DeMarco Bob DeMarco is the Founder of the Alzheimer's Reading Room (ARR). Bob is a recognized Influencer, speaker, and expert in the Alzheimer's and Dementia Community Worldwide. The Alzheimer's Reading Knowledge Base contains more than 4,000 articles, and the ARR has more than 343,000 links on the Internet. Bob lives in Delray Beach, FL.
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