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.
Ancelin
M L
ML
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.
de Roquefeuil
G
G
Ledésert
B
B
Bonnel
F
F
Cheminal
J C
JC
Ritchie
K
K
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