Journal of Pain Research (Oct 2015)

Exposure to general anesthesia and the risk of dementia

  • Yang CW,
  • Fuh JL

Journal volume & issue
Vol. 2015, no. default
pp. 711 – 718

Abstract

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Chih-Wen Yang,1,2 Jong-Ling Fuh2,3 1Department of Neurology, National Yang-Ming University Hospital, Ilan, 2National Yang-Ming University School of Medicine, 3Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China Abstract: Exposure to anesthesia and surgery has been hypothesized to increase the risk of developing Alzheimer's disease (AD). While the exact pathogenesis of AD remains unknown, it potentially involves specific proteins (eg, amyloid beta and tau) and neuroinflammation. A growing body of preclinical evidence also suggests that anesthetic agents interact with the components that mediate AD neuropathology at multiple levels. However, it remains unclear whether anesthesia and surgery are associated with an increased risk of AD in humans. To date, there have not been randomized controlled trials to provide evidence for such a causal relationship. Besides, observational studies showed inconsistent results. A meta-analysis of 15 case–control studies revealed no statistically significant association between general anesthesia and the development of AD (pooled odds ratio [OR] =1.05; P=0.43). However, a few retrospective cohort studies have demonstrated that exposure to anesthesia and surgery is associated with an increased risk of AD. Thus, well-designed studies with longer follow-up periods are still needed to define the role of anesthesia in relation to the development of AD. Keywords: anesthesia, surgery, dementia, Alzheimer's disease