Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug 18;13(1):13458.
doi: 10.1038/s41598-023-39300-5.

Prospective association of general anesthesia with risk of cognitive decline in a Chinese elderly community population

Wei Li  1   2 , Jianjun Jiang #  3 , Song Zhang #  4 , Ling Yue  5   6 , Shifu Xiao  7   8
Affiliations

Prospective association of general anesthesia with risk of cognitive decline in a Chinese elderly community population

Wei Li et al. Sci Rep. .

Abstract

As life expectancy increases and the population grows, the number of surgeries performed each year is likely to continue to increase. We evaluated whether surgery with general anesthesia increases risk for cognitive impairment in a Chinese elderly community population. The current data was obtained from the China Longitudinal Aging Study (cohort 1) and Shanghai Brain Aging study (cohort 2). Cohort 1 included 1545 elderly people with normal cognitive function, who underwent a screening process that included physical examination, medical history, baseline and 1-year follow-up assessments of cognitive function by a face-to-face interview. Cohort 2 included an additional 194 elderly people with normal cognitive function, all of whom, unlike cohort 1, underwent T1-phase MR imaging scans. In cohort 1, 127 elderly people with normal cognitive function transformed into mild cognitive impairment, 27 into dementia, while 1391 still maintained normal cognitive function. By using Cox regression analysis, we found that surgery with general anesthesia was a risk factor for cognitive impairment (p = 0.013, HR = 1.506, 95% CI 1.091-2.078); In cohort 2, we found that elderly people with a history of surgery with general anesthesia had lower Montreal Cognitive Assessment (MoCA) scores and smaller right amygdala volume (p < 0.05). Through correlation analysis, we found that the volume of the right amygdala was significantly correlated (p = 0.003, r = 0.212) with MoCA. Then by using the linear regression analysis (mediation model), we found that surgery with general anesthesia directly affected the MoCA score by affecting the volume of the right amygdala (B = 1.315, p = 0.036 95% CI 0.088-2.542). We confirm surgery with general anesthesia as a risk factor for cognitive impairment, and its mechanism may be related to its effect on the volume of the right amygdala.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Comparison of the risk of future cognitive impairment between patients undergoing general anesthesia and non-surgical controls.
Figure 2
Figure 2
Comparison of the volume of the right amygdala in patients undergoing general anesthesia and non-surgical controls.
Figure 3
Figure 3
There was an intrinsic relationship between general anesthesia, right amygdala volume, and MOCA score.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Silverstein JH. Cognition, anesthesia, and surgery. Int. Anesthesiol. Clin. 2014;52:42–57. - PMC - PubMed
    1. Wu L, Zhao H, Weng H, Ma D. Lasting effects of general anesthetics on the brain in the young and elderly: “Mixed picture” of neurotoxicity, neuroprotection and cognitive impairment. J. Anesth. 2019;33:321–335. - PMC - PubMed
    1. Chan MT, Cheng BC, Lee TM, Gin T. BIS-guided anesthesia decreases postoperative delirium and cognitive decline. J. Neurosurg. Anesthesiol. 2013;25:33–42. - PubMed
    1. Vlisides P, Xie Z. Neurotoxicity of general anesthetics: An update. Curr. Pharm. Des. 2012;18:6232–6240. - PubMed
    1. Mason SE, Noel-Storr A, Ritchie CW. The impact of general and regional anesthesia on the incidence of post-operative cognitive dysfunction and post-operative delirium: A systematic review with meta-analysis. J. Alzheimers Dis. 2010;22(Suppl 3):67–79. - PubMed

Publication types