Anesthesia, Surgery Linked to a Doubling of Dementia Risk

Several years ago I had a study participant, a former engineer who developed dementia incidental to a hernia operation.  So I did quite a bit of studying on that. I may have mentioned this in class, but I don’t always, however, we do talk about this problem in chapter 7 of our book on stopping Alzheimer’s. This new study published recently on Medscape is one of the latest and best to document this serious risk, and it provides some useful insights into possible causes. For which I propose some preventive measures below. 

What it doesn’t note, however, is that some meds are more likely to cause this problem than others, especially if a person already has some cognitive challenges. If you know someone over the age of 50 who is going in for surger

y strongly encourage them to talk with the anesthesiologist about this concern, especially if they are already having ANY memory problems. And they need to note those problems to the anesthesiologist. One of the theories is that if a person already has a build-up of plaque or is having any cognitive or memory issues the anesthesia will like exacerbate that and speed the decline. But anesthesiologists usually know which drugs are most and least likely to cause this effect.

A February 2007 Newswire out of Orlando.FL notes: “Isoflurane (Forane), a gener

al anesthetic inhalant, may cause cell death and generation of an Alzheimer’s-associated protein, recent research reveals.” So this for sure is one to avoid. But unfortunately it is not the only one. 

So what can a person do to reduce their risk, or what if you have a client who has e

xperienced memory loss as a result of an operation. This new report suggests two things. In the week or so leading up to the operation they may want to take the supplements SAMe and Acetyl-L-carnitine (ALCAR). These have been shown to inhibit the accumulation of Abeta plaque noted below, which contributes to Alzheimer’s. They may also want to take more vitamin E (mixed-tocopherols), this will help to prevent the calciu

m dysregulation noted below. The supplement Prevagen™ has also been shown to inhibit and even correct this calcium dysregulation, as has magnesium L-threonate, or malate. The supplement we studied now called Perce

ptiv™ contains SAMe, ALCAR and vitamin E. It also contains N-acetyl-cysteine (NAC).

Anyone going in for heart surgery should be made aware of a common problem called repurfusion. This occurs when blood flow is momentarily cut off, as when a person’s blood flow is switched from their heart to an artificial pump. It’s actually when the blood flow returns that most damage occurs. As a result 50% of people who have open heart surgery are plagued with lingering depression or memory problems or both following surgery. NAC and other antioxidant precursors, however, have been shown to reduce this risk as well. If you know someone going in for this type of surgery, email me and I will share a special report I prepared for a friend outlining their various options. 

Aug 01, 2013

Older patients who undergo anesthesia and surgery have a significantly increased risk for dementia, a large population-based study shows.

Investigators at TaipeiVeteransGeneralHospital in Taiwan found that 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.

“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.

The study was published online July 25 in the British Journal of Psychiatry.

Although generally considered safe, there is growing concern that anesthetic drugs may have neurodegenerative complications.

The investigators point out that in vivo studies and imaging studies have shown that “inhaled anesthetic agents can promote amyloid β peptide (Aβ) peptide oligomerisation and enhance Aβ-induced neurotoxicity.”

Other potential mechanisms of anesthetic-induced neurotoxicity include calcium dysregulation.

The researchers note that postoperative confusion/decline is generally thought to be short-lived, with normal cognition returning within a few days. However, they add that in some cases, it can last for weeks.

“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.

Br J Psychiatry. Published online July 25, 2013. Abstract

Medscape Medical News © 2013  WebMD, LLC

Send comments and news tips to news@medscape.net.

Cite this article: Anesthesia, Surgery Linked to a Doubling of Dementia Risk. Medscape. Aug 01, 2013.