@article{84b1844dbc2846948ab715d76b209bfc,
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 = "Funding Information: The authors thank Mr. Jeremiah Aakre, statistician for the MCSA. This study was supported by the NIH grants P50 AG016574 and U01 AG006786 (Petersen), by the Robert H. and Clarice Smith and Abigail van Buren Alzheimer's Disease Research Program, the Rochester Epidemiology Project (R01 AG034676, Principal Investigators: Walter A. Rocca, MD, and Jennifer St. Sauver, PhD) and the Mayo Clinic Center for Translational Sciences Activities (CTSA), grant number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Financial support for statistical analyses was provided by the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic. We, the authors, declare that we have no competing interests. Note: J.S. and D.R.S. have full access to all the study data and take responsibility for the integrity of the data and the accuracy of the data analysis. They also have final responsibility for the decision to submit for publication. Disclosures: D.S.K. previously served as deputy editor for the journal Neurology, and he serves on a Data Safety Monitoring Board for Lundbeck and for the Dominantly Inherited Alzheimer Network Trials Unit. He is an investigator in clinical trials sponsored by Biogen, Eli Lilly and Co, and TauRx Therapeutics Limited and receives research support from the NIH. M.M.M. has served as a consultant for Eli Lilly and has received unrestricted research grants from Biogen and Lundbeck. R.C.P. is the chair of Data Monitoring Committees for Pfizer Inc and Janssen Alzheimer Immunotherapy, LLC, and has served as a consultant for F. Hoffmann-La Roche Ltd; Merck and Co, Inc; and Genentech Inc. He receives royalties from sales of the book Mild Cognitive Impairment (Oxford University Press). J.S. T.N.W. P.J.S. A.C.H. D.P.M. D.R.S. and D.O.W. have nothing to disclose. Author Contributions:, J.S.: conception and design of the work, acquisition and interpretation of data, analysis and interpretation of data, drafting of the work and revisions for important intellectual content, study supervision, final approval of the version to be published. P.J.S.: drafting of the work and revisions for important intellectual content, statistical analysis and modeling, critical revisions of the work for important intellectual content, final approval of the manuscript. D.S.K.: acquisition and interpretation of data, critical revisions of the work for important intellectual content, final approval of the manuscript. M.M.M.: interpretation of data, critical revisions of the work for important intellectual content, final approval of the version to be published. R.C.P.: acquisition and interpretation of data, critical revisions of the work for important intellectual content, final approval of the manuscript. T.N.W.: interpretation of data, critical revisions of the work for important intellectual content, final approval. D.P.M.: critical revisions of the work for important intellectual content, final approval. A.C.H.: data analysis, critical revisions of the work. D.R.S.: analysis, critical revisions of the work for important intellectual content, final approval of the manuscript. D.O.W.: critical revisions of the work for important intellectual content, interpretation of data, and approval of the manuscript. Funding Information: Disclosures: D.S.K. previously served as deputy editor for the journal Neurology , and he serves on a Data Safety Monitoring Board for Lundbeck and for the Dominantly Inherited Alzheimer Network Trials Unit. He is an investigator in clinical trials sponsored by Biogen , Eli Lilly and Co , and TauRx Therapeutics Limited and receives research support from the NIH . M.M.M. has served as a consultant for Eli Lilly and has received unrestricted research grants from Biogen and Lundbeck . R.C.P. is the chair of Data Monitoring Committees for Pfizer Inc and Janssen Alzheimer Immunotherapy, LLC, and has served as a consultant for F. Hoffmann-La Roche Ltd; Merck and Co, Inc; and Genentech Inc. He receives royalties from sales of the book Mild Cognitive Impairment (Oxford University Press). J.S., T.N.W., P.J.S., A.C.H., D.P.M., D.R.S., and D.O.W. have nothing to disclose. Funding Information: This study was supported by the NIH grants P50 AG016574 and U01 AG006786 (Petersen), by the Robert H. and Clarice Smith and Abigail van Buren Alzheimer's Disease Research Program , the Rochester Epidemiology Project (R01 AG034676, Principal Investigators: Walter A. Rocca, MD, and Jennifer St. Sauver, PhD) and the Mayo Clinic Center for Translational Sciences Activities (CTSA), grant number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Financial support for statistical analyses was provided by the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic . Publisher Copyright: {\textcopyright} 2019 the Alzheimer's Association",
year = "2019",
month = oct,
doi = "10.1016/j.jalz.2019.06.4949",
language = "English (US)",
volume = "15",
pages = "1243--1252",
journal = "Alzheimer's and Dementia",
issn = "1552-5260",
publisher = "Elsevier Inc.",
number = "10",
}