Dissecting the possible influences of anesthesia and surgery on Alzheimer's disease. (April 2013)

• Record Type: Journal Article
• Authors: Evered, Lisbeth
• Is Part Of: Neurodegenerative disease management. Volume 3:Number 2(2013)
• Page Start: 115
• Page End: 122
• Publication Date: 2013-04
• Subjects: Nervous system -- Degeneration -- Periodicals; 616.8
• DOI: 10.2217/nmt.13.8
• Languages: English
• ISSNs: 1758-2024

Abstract

SUMMARY Alzheimer's disease (AD) is a neurodegenerative disease with late onset leading to significant morbidity and, ultimately, mortality. The prevalence of dementia in developed countries for individuals aged 65 years or over is approximately 10% currently, and the number of people with dementia is projected to increase by 350% by 2050. Older people frequently require anesthesia and surgery, such that by 2050 it is anticipated that 50% of all anesthetics will be administered to people aged 65 years or over. Anesthesia is known to be associated with neuropathological changes that mirror AD neuropathology in animal studies, and also with clinical cognitive changes known as postoperative cognitive dysfunction. This article will consider the evidence to date and whether we are able to dissect the possible influences of anesthesia and surgery. Identifying associations between postoperative cognitive dysfunction, dementia and AD is essential for developing strategies that will limit injury, and defer or prevent this disease. As a first step, preoperative cognitive assessment as part of routine perioperative management should become routine practice.