Katie J Schenning1, Charles F Murchison2, Nora C Mattek3, Lisa C Silbert4, Jeffrey A Kaye5, Joseph F Quinn6. 1. Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA. Electronic address: malcore@ohsu.edu. 2. Department of Neurology, Oregon Health and Science University, Portland, OR, USA. 3. Oregon Center for Aging and Technology, Oregon Health and Science University, Portland, OR, USA. 4. Department of Neurology, Portland Veterans Affairs Medical Center, Portland, OR, USA; Layton Aging and Alzheimer's Disease Center, Oregon Health and Science University, Portland, OR, USA. 5. Department of Neurology, Oregon Health and Science University, Portland, OR, USA; Oregon Center for Aging and Technology, Oregon Health and Science University, Portland, OR, USA; Department of Neurology, Portland Veterans Affairs Medical Center, Portland, OR, USA; Layton Aging and Alzheimer's Disease Center, Oregon Health and Science University, Portland, OR, USA. 6. Department of Neurology, Oregon Health and Science University, Portland, OR, USA; Department of Neurology, Portland Veterans Affairs Medical Center, Portland, OR, USA; Layton Aging and Alzheimer's Disease Center, Oregon Health and Science University, Portland, OR, USA.
Abstract
INTRODUCTION: In preclinical studies, surgery/anesthesia contribute to cognitive decline and enhance neuropathologic changes underlying Alzheimer's disease (AD). Nevertheless, the link between surgery, anesthesia, apolipoprotein E ε4 (APOE ε4), and AD remains unclear. METHODS: We performed a retrospective cohort analysis of two prospective longitudinal aging studies. Mixed-effects statistical models were used to assess the relationship between surgical/anesthetic exposure, the APOE genotype, and rate of change in measures of cognition, function, and brain volumes. RESULTS: The surgical group (n = 182) experienced a more rapid rate of deterioration compared with the nonsurgical group (n = 345) in several cognitive, functional, and brain magnetic resonance imaging measures. Furthermore, there was a significant synergistic effect of anesthesia/surgery exposure and presence of the APOE ε4 allele in the decline of multiple cognitive and functional measures. DISCUSSION: These data provide insight into the role of surgical exposure as a risk factor for cognitive and functional decline in older adults.
INTRODUCTION: In preclinical studies, surgery/anesthesia contribute to cognitive decline and enhance neuropathologic changes underlying Alzheimer's disease (AD). Nevertheless, the link between surgery, anesthesia, apolipoprotein E ε4 (APOE ε4), and AD remains unclear. METHODS: We performed a retrospective cohort analysis of two prospective longitudinal aging studies. Mixed-effects statistical models were used to assess the relationship between surgical/anesthetic exposure, the APOE genotype, and rate of change in measures of cognition, function, and brain volumes. RESULTS: The surgical group (n = 182) experienced a more rapid rate of deterioration compared with the nonsurgical group (n = 345) in several cognitive, functional, and brain magnetic resonance imaging measures. Furthermore, there was a significant synergistic effect of anesthesia/surgery exposure and presence of the APOE ε4 allele in the decline of multiple cognitive and functional measures. DISCUSSION: These data provide insight into the role of surgical exposure as a risk factor for cognitive and functional decline in older adults.
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