General anesthesia is associated with short-term cognitive dysfunction in the elderly, but evidence for long-term impairment or acceleration of dementia is inconsistent due to study heterogeneity.
Systematic Review
Does general anesthesia cause long-term cognitive impairment or senile dementia in elderly subjects?
General anesthesia is associated with short-term cognitive dysfunction in the elderly, but its role in long-term cognitive impairment or dementia remains inconsistent and likely influenced by other factors.
Exposure to general anesthesia has been suggested as a possible cause of long-term cognitive impairment in elderly subjects. The present study reviews the literature in this field in order to describe postoperative cognitive impairment in elderly populations, to determine to what extent this may be attributed to anesthetic agents, and to consider evidence of a causal relationship between anesthesia and onset of senile dementia. A systematic literature search was conducted using five bibliographic databases (PASCAL, Medline, Excerpta Medica, Psychological Abstracts, and Science Citation Index). Significant cognitive dysfunction was found to be common in elderly persons 1 to 3 days after surgery, but reports of longer-term impairment are inconsistent due to the heterogeneity of the procedures used and populations targeted in such studies. Incidence rates vary widely according to type of surgery, suggesting that factors other than anesthesia explain a significant proportion of the observed variance. Anesthesia appears to be associated with longerterm cognitive disorder and the acceleration of senile dementia, but only in a small number of cases, suggesting the existence of other interacting etiological factors.
Ritchie et al. (Mon,) conducted a systematic review in Cognitive impairment and senile dementia. General anesthesia was evaluated on Postoperative cognitive impairment and onset of senile dementia. General anesthesia is associated with short-term cognitive dysfunction in the elderly, but evidence for long-term impairment or acceleration of dementia is inconsistent due to study heterogeneity.
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