Anesthesia and surgery linked to a doubling of dementia risk, reports new study

Dementia
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As rates of dementia and Alzheimer's disease continue to soar, a new study is certain to result in shock for many studying these troubling conditions. Older patients who undergo anesthesia and surgery significantly increase their risk for dementia, according to a large population-based study published in the British Journal of Psychiatry, August 1, 2013.

Patients older than 50 years who underwent anesthesia for the first time had nearly a 2-fold increased risk for dementia, mainly Alzheimer's disease, compared with nonanesthetized patients, reported investigators at Taipei Veterans General Hospital in Taiwan. "The results of our nationwide population-based study suggest that patients who undergo anesthesia and surgery may be at increased risk of developing dementia. Anesthesia and surgery are inseparable in clinical settings. Thus, it is difficult to establish whether the increased risk of dementia development we observed was attributable to the anesthesia per se, the surgical process, or both," principal investigator Jong-Ling Fuh, MD, said in a statement..

Study Implications for Anesthesia
So what does this mean for a widely used method of reducing pain during surgery? Medscape reports that "although generally considered safe, there is growing concern that anesthetic drugs may have neurodegenerative complications." And the investigators noted that "inhaled anesthetic agents can promote amyloid β peptide (Aβ) peptide oligomerisation and enhance Aβ-induced neurotoxicity."

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Although some older people experience only short-term postoperative mental decline and confusion, lasting only a few days, they discovered that in some people, it can last for weeks.

Detail on the Study
The study cohort included 24,901 patients aged 50 years and older who were anesthetized for the first time since 1995 between January 1, 2004, and December 31, 2007, and a control group of 110,972 randomly selected age- and sex-matched patients. All participants were followed until December 31, 2010, to identify the emergence of dementia.

Investigators for the research from Taipei Veterans General Hospital in Taiwan conducted a two to seven year follow-up. Their follow-up revealed that 661 of 24,901 anesthetized patients (2.65%) and 1530 of the 110,972 nonanesthetized patients (1.39%) were diagnosed with dementia, equating to a nearly 2-fold increased risk for dementia in the anesthesia/surgery group (hazard ratio, 1.99; 95% confidence interval, 1.81 - 2.17).

"Although anesthesia and surgery have provided immeasurable health and social benefits, our observations in this piece of research highlight the need for further studies to understand the association and causality between anesthesia with surgery and subsequent dementia," said Dr. Fuh.

Citation:
BJ Psych
July 25, 2013,
doi: 10.1192/bjp.bp.112.119610

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