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The minor decline in brain function could affect people with low cognitive function or pre-existing mild cognitive impairment who are considering surgery with general anesthesia. In older adults with borderline cognitive reserve that is not yet clinically obvious, exposure to anesthesia and surgery may expose underlying problems with memory and thinking.
Juraj Sprung, M.D., Ph.D., a Mayo Clinic anesthesiologist, said cognitive dysfunction is possible after surgery, alternative strategies should be discussed with patients before surgery is undertaken for those at high risk. Preoperative cognitive evaluations of the elderly is necessary before surgery to discover an individual’s risk of exposure to surgery and anesthesia.
Animal studies have showed that exposure to inhaled anesthetics may be related to brain changes linked to Alzheimer’s disease; however, most previous studies in humans have not consistently shown association between anesthesia and impaired brain function.
Researchers used resources from the Mayo Clinic Study of Aging, a long-term epidemiologic and population-based prospective study about cognitive changes related to aging. Participants in Olmsted County, Minnesota, undergo cognitive assessments at roughly 15-month intervals. The group included 1,819 participants, ages 70 to 89 at the time of study enrollment.
The researchers analyzed whether exposure to surgery and anesthesia during the period 20 years before enrollment was associated with cognitive decline and whether exposure to anesthesia after study enrollment as an older adult was associated with a cognitive change.
Older adults often experience cognitive decline as part of the normal aging process, decline following exposure to anesthesia and surgery was found to be slightly increased beyond what is associated with aging.