Surgery is associated with ventricular enlargement as well as cognitive and functional decline

Katie J Schenning; Charles F Murchison; Nora C Mattek; Lisa C Silbert; Jeffrey A Kaye; Joseph F Quinn

doi:10.1016/j.jalz.2015.10.004

Surgery is associated with ventricular enlargement as well as cognitive and functional decline

Alzheimers Dement. 2016 May;12(5):590-7. doi: 10.1016/j.jalz.2015.10.004. Epub 2015 Nov 25.

Authors

Katie J Schenning¹, Charles F Murchison², Nora C Mattek³, Lisa C Silbert⁴, Jeffrey A Kaye⁵, Joseph F Quinn⁶

Affiliations

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.

Keywords: Alzheimer's disease; Anesthesia; Apolipoprotein E ε4; Cognitive decline; Cohort study; Epidemiology; Postoperative; Surgery; Volumetric MRI.

Publication types

Research Support, U.S. Gov't, P.H.S.
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Activities of Daily Living*
Aged, 80 and over
Alzheimer Disease / genetics
Apolipoprotein E4 / genetics
Cerebral Ventricles / abnormalities*
Cognition Disorders / etiology*
Cognition Disorders / genetics
Disease Progression
Female
Genotype
Humans
Magnetic Resonance Imaging / methods
Male
Neuropsychological Tests / statistics & numerical data
Retrospective Studies
Risk Factors
Surgical Procedures, Operative / adverse effects*

Substances

Apolipoprotein E4

Abstract

Publication types

MeSH terms

Substances

Grants and funding