Cognitive function after surgery with regional or general anesthesia: A population-based study

Juraj Sprung; Phillip J. Schulte; David S. Knopman; Michelle M. Mielke; Ronald C. Petersen; Toby N. Weingarten; David P. Martin; Andrew C. Hanson; Darrell R. Schroeder; David O. Warner

doi:10.1016/j.jalz.2019.06.4949

Cognitive function after surgery with regional or general anesthesia: A population-based study

Juraj Sprung, Phillip J. Schulte, David S. Knopman, Michelle M. Mielke, Ronald C. Petersen, Toby N. Weingarten, David P. Martin, Andrew C. Hanson, Darrell R. Schroeder, David O. Warner

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

Introduction: Our aim was to examine whether surgery with regional anesthesia (RA) is associated with accelerated long-term cognitive decline comparable with that previously reported after general anesthesia (GA). Methods: Longitudinal cognitive function was analyzed in a cohort of 1819 older adults. Models assessed the rate of change in global and domain-specific cognition over time in participants exposed to RA or GA. Results: When compared with those unexposed to anesthesia, the postoperative rate of change of the cognitive global z-score was greater in those exposed to both RA (difference in annual decline of −0.041, P = .011) and GA (−0.061, P < .001); these rates did not differ. In analysis of the domain-specific scores, an accelerated decline in memory was observed after GA (−0.065, P < .001) but not RA (−0.011, P = .565). Conclusions: Older adults undergoing surgery with RA experience decline of global cognition similar to those receiving GA; however, memory was not affected.

Original language	English (US)
Pages (from-to)	1243-1252
Number of pages	10
Journal	Alzheimer's and Dementia
Volume	15
Issue number	10
DOIs	https://doi.org/10.1016/j.jalz.2019.06.4949
State	Published - Oct 2019

Keywords

Anesthesia: regional
Attention/executive function
Cognitive aging
Cognitive z-scores
Domains: memory
General
Global cognitive scores
Language
Mayo Clinic Study of Aging
Older adults
Surgery
Visuospatial skills

ASJC Scopus subject areas

Epidemiology
Health Policy
Developmental Neuroscience
Clinical Neurology
Geriatrics and Gerontology
Cellular and Molecular Neuroscience
Psychiatry and Mental health

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10.1016/j.jalz.2019.06.4949

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title = "Cognitive function after surgery with regional or general anesthesia: A population-based study",

abstract = "Introduction: Our aim was to examine whether surgery with regional anesthesia (RA) is associated with accelerated long-term cognitive decline comparable with that previously reported after general anesthesia (GA). Methods: Longitudinal cognitive function was analyzed in a cohort of 1819 older adults. Models assessed the rate of change in global and domain-specific cognition over time in participants exposed to RA or GA. Results: When compared with those unexposed to anesthesia, the postoperative rate of change of the cognitive global z-score was greater in those exposed to both RA (difference in annual decline of −0.041, P = .011) and GA (−0.061, P < .001); these rates did not differ. In analysis of the domain-specific scores, an accelerated decline in memory was observed after GA (−0.065, P < .001) but not RA (−0.011, P = .565). Conclusions: Older adults undergoing surgery with RA experience decline of global cognition similar to those receiving GA; however, memory was not affected.",

keywords = "Anesthesia: regional, Attention/executive function, Cognitive aging, Cognitive z-scores, Domains: memory, General, Global cognitive scores, Language, Mayo Clinic Study of Aging, Older adults, Surgery, Visuospatial skills",

author = "Juraj Sprung and Schulte, {Phillip J.} and Knopman, {David S.} and Mielke, {Michelle M.} and Petersen, {Ronald C.} and Weingarten, {Toby N.} and Martin, {David P.} and Hanson, {Andrew C.} and Schroeder, {Darrell R.} and Warner, {David O.}",

note = "Publisher Copyright: {\textcopyright} 2019 the Alzheimer's Association",

year = "2019",

month = oct,

doi = "10.1016/j.jalz.2019.06.4949",

language = "English (US)",

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T1 - Cognitive function after surgery with regional or general anesthesia

T2 - A population-based study

AU - Sprung, Juraj

AU - Schulte, Phillip J.

AU - Knopman, David S.

AU - Mielke, Michelle M.

AU - Petersen, Ronald C.

AU - Weingarten, Toby N.

AU - Martin, David P.

AU - Hanson, Andrew C.

AU - Schroeder, Darrell R.

AU - Warner, David O.

PY - 2019/10

Y1 - 2019/10

N2 - Introduction: Our aim was to examine whether surgery with regional anesthesia (RA) is associated with accelerated long-term cognitive decline comparable with that previously reported after general anesthesia (GA). Methods: Longitudinal cognitive function was analyzed in a cohort of 1819 older adults. Models assessed the rate of change in global and domain-specific cognition over time in participants exposed to RA or GA. Results: When compared with those unexposed to anesthesia, the postoperative rate of change of the cognitive global z-score was greater in those exposed to both RA (difference in annual decline of −0.041, P = .011) and GA (−0.061, P < .001); these rates did not differ. In analysis of the domain-specific scores, an accelerated decline in memory was observed after GA (−0.065, P < .001) but not RA (−0.011, P = .565). Conclusions: Older adults undergoing surgery with RA experience decline of global cognition similar to those receiving GA; however, memory was not affected.

AB - Introduction: Our aim was to examine whether surgery with regional anesthesia (RA) is associated with accelerated long-term cognitive decline comparable with that previously reported after general anesthesia (GA). Methods: Longitudinal cognitive function was analyzed in a cohort of 1819 older adults. Models assessed the rate of change in global and domain-specific cognition over time in participants exposed to RA or GA. Results: When compared with those unexposed to anesthesia, the postoperative rate of change of the cognitive global z-score was greater in those exposed to both RA (difference in annual decline of −0.041, P = .011) and GA (−0.061, P < .001); these rates did not differ. In analysis of the domain-specific scores, an accelerated decline in memory was observed after GA (−0.065, P < .001) but not RA (−0.011, P = .565). Conclusions: Older adults undergoing surgery with RA experience decline of global cognition similar to those receiving GA; however, memory was not affected.

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KW - General

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KW - Language

KW - Mayo Clinic Study of Aging

KW - Older adults

KW - Surgery

KW - Visuospatial skills

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Cognitive function after surgery with regional or general anesthesia: A population-based study

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