Exposure to anaesthetic agents, cognitive functioning and depressive symptomatology in the elderly.
BACKGROUND
Anaesthesia could provoke persistent alterations in specific cognitive domains in the elderly where ageing-related neuronal changes may exacerbate pharmacotoxic effects.


OBJECTIVE
To evaluate anaesthesia effects on the incidence of cognitive dysfunction after orthopaedic surgery in elderly patients.


METHODS
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.
INSERM EPI-9930, Epidemiology and Clinical Research in Nervous System Pathologies, CLRC Val d'Aurelle, Bat. Rech. Rdc, Parc Euromédecine, 34298 Montpellier Cedex 5, France.
M L
ML
Ancelin
G
G
de Roquefeuil
B
B
Ledésert
F
F
Bonnel
J C
JC
Cheminal
K
K
Ritchie
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000379:methods; D000777:Anesthetics / Q000009:adverse effects*; D003072:Cognition Disorders / Q000139:chemically induced*; D003866:Depressive Disorder / Q000523:psychology*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000139:chemically induced; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000534:rehabilitation; D011594:Psychometrics; D012044:Regression Analysis; D012307:Risk Factors
D000777:Anesthetics