Abstract
Objective
To examine whether exposure to general anesthesia for operations and procedures after
the age of 40 years is associated with incident mild cognitive impairment (MCI) in
elderly patients.
Patients and Methods
A population-based, prospective cohort of Olmsted County, Minnesota, residents aged
70 to 89 years at enrollment, underwent baseline and 15-month interval evaluations
that included the Clinical Dementia Rating scale, a neurologic evaluation, and neuropsychological
testing. Anesthesia records after the age of 40 years until last evaluation for MCI
were abstracted. Proportional hazards regression, adjusting for other known MCI risk
factors, was used to assess whether exposure to surgical general anesthesia after
the age of 40 years is associated with the incidence of MCI.
Results
Of 1731 participants (mean age, 79 years), 536 (31.0%) developed MCI during a median
follow-up of 4.8 years. Anesthesia exposure was not associated with MCI when analyzed
as a dichotomous variable (any vs none; adjusted hazard ratio [HR], 1.07; 95% CI,
0.83-1.37; P=.61), the number of exposures (adjusted HR, 1.05; 95% CI, 0.78-1.42; adjusted HR,
1.12; 95% CI, 0.86-1.47; and adjusted HR, 1.02; 95% CI, 0.76-1.34, for 1, 2-3, and
≥4 exposures compared with no exposure as the reference; P=.73), or the total cumulative duration of exposure (adjusted HR, 1.00; 95% CI, 0.98-1.01,
per 60-minute increase; P=.83). In secondary sensitivity analyses, anesthesia after 60 years of age was associated
with incident MCI (adjusted HR, 1.25; 95% CI, 1.02-1.55; P=.04), as was exposure in the previous 20 and 10 years.
Conclusion
We found no significant association between cumulative exposure to surgical anesthesia
after 40 years of age and MCI. However, these data do not exclude the possibility
that anesthetic exposures occurring later in life may be associated with an increase
in the rate of incident MCI.
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Article Info
Publication History
Published online: January 20, 2016
Footnotes
Dr Farmer is now with the Department of Surgery, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD.
Grant Support: This study was made possible by the Rochester Epidemiology Project (grant number R01-AG034676; Principal Investigator: Walter A. Rocca, MD, MPH, and Barbara P. Yawn, MD, MSc). This study was supported by grants P50 AG016574 , U01 AG006786 , K01 MH068351 , and K01 AG028573 from the National Institutes of Health , by the Robert H. and Clarice Smith and Abigail van Buren Alzheimer's Disease Research Program, the Mayo Clinic Center for Translational Sciences Activities, and grant UL1 TR000135 from the National Center for Advancing Translational Sciences .
Potential Competing Interests: Dr Knopman serves as deputy editor for the journal Neurology and serves on a data safety monitoring board for Lundbeck Pharmaceuticals and for the Dominantly Inherited Alzheimer's Disease Treatment Unit. He has served on a data safety monitoring board for Lilly Pharmaceuticals, served as a consultant to TauRX, was an investigator in clinical trials sponsored by Baxter and Elan Pharmaceuticals in the past 2 years, and receives research support from the National Institutes of Health. Dr Petersen is the chair of data monitoring committees for Pfizer and Janssen Alzheimer Immunotherapy and has served as a consultant for Roche, Merck, and Genentech. He receives royalties from the publication of Mild Cognitive Impairment by Oxford University Press. Dr Roberts receives research support from the National Institutes of Health and the Driskill Foundation and previously received research support from AbbVie Health Economics and Outcomes Research. No other disclosures were reported.
Identification
Copyright
© 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
