Juraj Sprung1, Phillip J Schulte2, David S Knopman3, Michelle M Mielke4, Ronald C Petersen3, Toby N Weingarten5, David P Martin5, Andrew C Hanson2, Darrell R Schroeder2, David O Warner5. 1. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA. Electronic address: sprung.juraj@mayo.edu. 2. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA. 3. Department of Neurology, Mayo Clinic, Rochester, MN, USA; Division of Epidemiology, Mayo Clinic, Rochester, MN, USA. 4. Division of Epidemiology, Mayo Clinic, Rochester, MN, USA. 5. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
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.
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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