Doctor’s verdict – Alzheimer’s and Anesthesia

Brain Dark BlueWe recently came across an article on the effects of anesthesia on Alzheimer’s, and how the two of them don’t mix well. You can read the article here – Alzheimer’s and Anesthesia.

We asked our in-house Geriatric Physician Dr Chawla to comment on this. Dr. Satish Chawla MD, FACP, AIIMS, who is a retired Geriatric Physician from the United States Navy. He is an expert in geriatric medicine. Here is what he had to say –

A recent article was quoted by Archana regarding the risk ofAlzheimer’s following surgery/anesthesia. This has been the topic of intense debate in medical circles for many decades. My own experience from my practicing days left no doubt in my mind that this was a real phenomenon, especially  obvious in people who had undergone open heart surgery. In those days circulation of blood was supported by a heart-lung machine and this unnatural process was blamed for this finding.

People recovering from anesthesia have a period of confusion and disorientation with a varying period of delusionary state not dissimilar to AD. This condition is temporary but a trailing period of memory dysfunction, lack of attention etc. persist for some time. It is true that in some patients this decrease in cognition become permanent and indeed progressive.

Surgery is a state of intense stress on the body activating stress hormones, causing inflammation in the neuronal system, making the blood brain barrier porous, reducing the oxygen supply and oxygen delivery to the tissues. It is hard to differentiate the roles of surgery vs the anesthesia in the ensuing cognitive decline.

Without doubt the presence of AD prior to surgery increases the risk of post surgical decline in cognition. Whether  surgery was causative for the increase in cognitive dysfunction is open for discussion but certainly is a risk factor. Various authors have tried to differentiate between the various anesthetic agents or the depth of anesthesia as variables  The exact mechanism by which these agents act to cause anesthesia is not known and this fact makes it difficult to separate them by their effect on the neural tissues. What is becoming clearer is that these agents are able to stimulate the formation of the two proteins that have been implicated in the neuro-degenerative diseases. (Tau and Beta-amyloid)

In summary, while it is not clear if surgery or the accompanying anesthesia causes worsening of cognitive decline it would seem prudent to avoid surgery where possible, minimize surgery where necessary and work with a physician familiar with the needs of the elderly pre and post surgery.


 

We at Samvedna Senior Care aim to help seniors live happy, active and independent lives, in the comfort of their home and community through interactive caregiving.

Samvedna Senior Care was established in October 2013 with two complementary goals – firstly to provide quality home care services to seniors with limited mobility or dementia and hence social interaction, and secondly to facilitate stimulating community interaction and participation.

Our Dementia Care services are

At-home services –
Dementia intervention activities by trained Care Specialists (already mentioned above). These services are available in Delhi NCR and Guwahati
More – http://www.samvednacare.com/dementia-care
Please call us for more info – Delhi NCR – 98184 21446, 124 4229659 | Guwahati – 9864015872

Dementia Support Group –
Our Dementia Support group in Delhi NCR and Guwahati is a platform for caregivers to share feelings and support each other.
More – http://www.samvednacare.org/our-work/dementia-care
Please call us for more info – Delhi NCR – 98184 21446, 124 4229659 | Guwahati – 9864015872

Cognitive Wellness Programme, Sector 57  Gurgaon  –
Samvedna’s Cognitive Wellness Programme is designed for seniors with mild cognitive impairment, early dementia or Parkinson’s, and elderly lacking in enthusiasm and motivation. The aim is to stimulate the mind of the elderly to slow the progression of the disease or impairment. The sessions are 3 days a week, 11AM-1PM.
More – http://www.samvednacare.org/our-work/cognitive-wellness-programme

 

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