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Exposure to anaesthetic agents, cognitive functioning and depressive symptomatology in the elderly
M L Ancelin1, G de Roquefeuil, B Ledésert
1INSERM EPI-9930, Epidemiology and Clinical Research in Nervous System Pathologies, CLRC Val d'Aurelle, Bat. Rech. Rdc, Parc Euromédecine, 34298 Montpellier Cedex 5, France.
Background:
Anaesthesia could provoke persistent alterations in specific cognitive domains in the elderly where ageing-related neuronal changes may exacerbate pharmacotoxic effects.
Aims:
To evaluate anaesthesia effects on the incidence of cognitive dysfunction after orthopaedic surgery in elderly patients.
Method:
A total of 140 patients over the age of 64 years completed a full range of computerised cognitive tests. The study takes into account effects of pre-operative cognitive dysfunction, depressive symptomatology and ability to perform activities of daily living.
Results:
Postoperative cognitive decline persisted for up to 3 months in 56% of subjects. Dysfunction was limited to verbal, visuo-spatial and semantic abilities and secondary and implicit memory. Age, low educational level, pre-operative cognitive impairment or depression are risk factors.
Conclusions:
Cognitive functions are not equally affected, type of impairment being determined by the risk factors described above and anaesthesia type.