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How General Anesthesia Can Affect an Elder’s Mind

Wednesday, November 18, 2015

How General Anesthesia Can Affect an Elder’s Mind

As we get older our bodies become weaker or problems arise and more likely than not you will need to have surgery and will require general anesthesia. As we age the way our bodies process drugs changes and our overall metabolic rate is slower.

According to "General anesthesia does carry a higher risk for the elderly population," says Damon Raskin, M.D., a board-certified internist and medical director for two skilled nursing facilities. According to Raskin, it takes longer for an older person's body to rid itself of the chemicals involved in anesthesia, which can in turn prolong the negative effects of the drugs.

When you compound surgery with other health conditions, such as, heart disease and diabetes the problem with anesthesia becomes more complex.

Some people with more complex diseases may have trouble with confusion or hallucinating, and these signs may not appear until days after a surgery. These types of problems can disrupt the post-operative care and must be taken into account when creating a care plan for an elderly patient coming out from under general anesthesia.

Anesthesia, delirium and dementia

With the elderly, the conditions of dementia and delirium can sometimes be confused, and it is important to understand the difference and the signs of each condition.

While these ailments share similar symptoms—confusion, problems with perception, mood swings and decreased cognition—there is one crucial difference that separates them. Delirium refers to abrupt, temporary changes in a person's mental functioning, whereas dementia describes a more gradual, consistent decline in cognitive capacity.

Delirium is a common cognitive after-effect of general anesthesia, particularly for the elderly. This has led to a flurry of research studies aimed at determining whether being "put under" can cause permanent brain changes, even dementia.

The problem with the studies is the results came back both ways, reports show that anesthesia could increase risk of dementia, and others that show is could not.

Most evidence suggests that receiving general anesthesia during the course of surgery does not increase the likelihood of developing lasting dementia. Yet it is clear something is going on: Recent experiments on animals and human cells show that anesthesia can increase the buildup of the proteins thought to underlie Alzheimer’s disease, especially in high doses.

Avoiding post-op problems

As a caregiver, it can be hard to know what to do when a senior needs surgery.

The link between dementia and general anesthesia remains fuzzy, but there's no doubt that surgery can cause lingering physical and cognitive issues for older adults.

Post-operative cognitive dysfunction (POCD) isn't synonymous with Alzheimer's, or other forms of dementia, but it is a mental condition whose symptoms can mimic those of more permanent forms of cognitive impairment.

When an elderly loved one is preparing for surgery, the best thing you can do for them is insist they participate in a thorough pre-operative evaluation. The pre-operative evaluation will give the surgeons and anesthesiologists information about your conditions and medical background. It will inform them of the medications being taken, any pre-existing conditions that could be detrimental to the surgery, and all supplements being taken, because just like medication, they can have adverse reactions with anesthesia drugs.

The doctor in charge of coordinating your loved one's surgery should make sure this and any other relevant information is communicated to their surgical team. You and your loved one may also meet with the anesthesiologist in person, prior to the procedure, to go over important medical considerations.

Undergoing general anesthesia carries risks for people of every age, but making sure the surgical team is up-to-date on your loved one's medical conditions will reduce the risk of potentially adverse mental side effects.


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