Cognitive function after surgery with regional or general anesthesia: A population‐based study. Issue 10 (5th September 2019)

• Record Type: Journal Article
• Authors: Sprung, Juraj; Schulte, Phillip J.; Knopman, David S.; Mielke, Michelle M.; Petersen, Ronald C.; Weingarten, Toby N.; Martin, David P.; Hanson, Andrew C.; Schroeder, Darrell R.; Warner, David O.
• Is Part Of: Alzheimer's & dementia. Volume 15:Issue 10(2019)
• Page Start: 1243
• Page End: 1252
• Publication Date: 2019-09-05
• Subjects: Anesthesia: regional -- General -- Cognitive aging -- Cognitive z‐scores -- Global cognitive scores -- Domains: memory -- Attention/executive function -- Language -- Visuospatial skills -- Mayo Clinic Study of Aging -- Older adults -- Surgery; Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1016/j.jalz.2019.06.4949
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Introduction: Our aim was to examine whether surgery with regional anesthesia (RA) is associated with accelerated long‐term cognitive decline comparable with that previously reported after general anesthesia (GA). Methods: Longitudinal cognitive function was analyzed in a cohort of 1819 older adults. Models assessed the rate of change in global and domain‐specific cognition over time in participants exposed to RA or GA. Results: When compared with those unexposed to anesthesia, the postoperative rate of change of the cognitive global z‐score was greater in those exposed to both RA (difference in annual decline of −0.041, P = .011) and GA (−0.061, P < .001); these rates did not differ. In analysis of the domain‐specific scores, an accelerated decline in memory was observed after GA (−0.065, P < .001) but not RA (−0.011, P = .565). Conclusions: Older adults undergoing surgery with RA experience decline of global cognition similar to those receiving GA; however, memory was not affected. Highlights: Exposure to surgery with anesthesia is associated with accelerated global cognitive decline. The decline in global cognitive function is similar after regional and general anesthesia. Accelerated decline in memory may occur after surgery with general but not regional anesthesia.