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Surgery Doesn’t Boost Risk of Alzheimer Disease

Experts have been concerned that anesthesia for surgery might boost the risk of Alzheimer disease. Doctors from the Mayo Clinic have reassuring news.
Dementia and Alzheimer’s disease medical concept, 3D illustration. Memory loss, brain aging. Conceptual image showing blurred brain with loss of neuronal networks

There’s good news and bad news about surgery under general anesthesia. Anesthesiologists have been debating the effects or surgical anesthetics on brain function for years. Some research suggests that cognitive dysfunction is a temporary consequence of anesthesia. Other studies indicate that the brain problems may last longer. Certain physicians have worried that surgery with general anesthesia could boos the risk of Alzheimer disease.

How Does Anesthesia Affect the Risk of Alzheimer Disease?

A new study from the Mayo Clinic indicates that older adults undergoing surgery with general anesthesia experienced some measure of cognitive decline (British Journal of Anaesthesia, online March 10, 2020). At the same time, the cerebral cortex became thinner.

The scientists reported that finding last year (British Journal of Anaesthesia, Dec. 2019). At that time, they reported no link between prior surgery with general anesthesia and brain infarcts. These tiny blood clots in the brain can cause cognitive impairment, although they are different from Alzheimer disease. Still, older adults contemplating surgery should feel somewhat reassured that there is no connection with infarcts.

Cognitive decline is worrisome. On the other hand, the researchers did not find any evidence of an increased risk of Alzheimer’s disease. In particular, they saw no increased deposits of amyloid plaques, which are a marker of Alzheimer’s pathology.

Reassuring News:

The authors of this study published in the British Journal of Anaesthesia reassure their medical colleagues that surgery with general anesthesia is not related to Alzheimer disease. They do acknowledge, however, that such procedures may be linked to modest cortical thinning in the brain and slightly accelerated cognitive decline over time.

Some readers have reported experiencing brain fog, insomnia or confusion following surgery with anesthesia. You can read their stories here. If you have had surgery with general anesthesia and want to share your experience, add your comment below.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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Citations
  • Sprung J et al, "Exposure to surgery with general anaesthesia during adult life is not associated with increased brain amyloid deposition in older adults." British Journal of Anaesthesia, online March 10, 2020. DOI: 10.1016/j.bja.2020.01.015
  • Sprung J et al, "Exposure to surgery under general anaesthesia and brain magnetic resonance imaging changes in older adults." British Journal of Anaesthesia, Dec. 2019. DOI: 10.1016/j.bja.2019.08.024
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My mother was diagnosed with Alzheimer’s disease and has passed away. She had been over-sedated (her doctor informed me of this) while having heart valve surgery. They thought the surgery would take much longer than it did. The surgery was done to re-do surgery that had been done the year previous in which they had tried just cleaning the valve out. That did not work, and she and others had to have the valve replaced after the cleaning procedure. It took her 2 days after she woke up to recognize my brother and myself. We have always thought that she never was the same after that surgery. Hence, I do not agree with this article.

Every time my mom had surgery, there was an increase in her dementia. I don’t agree with this article. Mom’s was clear and obvious!

That may be but be aware of damage to vocal cords because of intubation….happened to me!

My husband had kidney surgery about four years ago at age 78. I noticed a fogginess and difficulty with thought processes immediately after surgery, which seemed to clear up. However, over the course of the following year, I noticed a decline, and he was diagnosed with mild cognitive decline. He continued in his downward trajectory, and he has now been diagnosed with dementia and I’m seeing a rapid decline. Prior to his surgery, I had not noticed any cognitive problems. Even before reading this article, I wondered if it was the anesthesia from his surgery.

20 years ago my 80-year-old father came out from anesthesia a raving fool – twice. I could find nothing about that on the Internet at the time. Following his death, I wrote to a national society of anesthesiologists to report this and a similar outcome for an in-law who has hallucinations for the rest of her life.

The anesthesiologists’ work was done before the symptoms appeared, and they were probably not informed.

I’m sure the BJA article is accurate, but anecdotal evidence contradicts the findings. Both my parents had surgery in later life, my father never recovered from his procedure at age 70, and died in a fetal position from ‘dementia’ four horrible years later. My mother’s post-surgery cognitive decline, although less severe, was marked and difficult. The problem with essentially statistical studies is the exception often gets drowned out by a preponderance of other data, and the statistically insignificant result is lost.

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