title: Anesthesia and incident dementia: a population-based, nested, case-control study.
abstract: OBJECTIVE
  To test the hypothesis that exposure to procedures requiring general anesthesia during adulthood is not significantly associated with incident dementia using a retrospective, population-based, nested, case-control study design.
  
  
  METHODS
  Using the Rochester Epidemiology Project and the Mayo Clinic Alzheimer's Disease Patient Registry, residents of Olmsted County, Minnesota, diagnosed as having dementia between January 1, 1985, and December 31, 1994, were identified. For each incident case, a sex- and age-matched control was randomly selected from the general pool of Olmsted County residents who were dementia free in the index year of dementia diagnosis. Medical records were reviewed to determine exposures to procedures requiring anesthesia after age 45 years and before the index year. Data were analyzed using logistic regression.
  
  
  RESULTS
  We analyzed 877 cases of dementia, each with a corresponding control. Of the dementia cases, 615 (70%) underwent 1681 procedures requiring general anesthesia; of the controls, 636 (73%) underwent 1638 procedures. When assessed as a dichotomous variable, anesthetic exposure was not significantly associated with dementia (odds ratio, 0.89; 95% CI, 0.73-1.10; P=.27). In addition, no significant association was found when exposure was quantified as number of procedures (odds ratios, 0.87, 0.86, and 1.0 for 1, 2-3, and ≥4 exposures, respectively, compared with none; P=.51).
  
  
  CONCLUSIONS
  This study found no significant association between exposure to procedures requiring general anesthesia after age 45 years and incident dementia.
authors: Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA. sprung.juraj@mayo.edu
authors: Juraj
authors: J
authors: Sprung
authors: Christopher J
authors: CJ
authors: Jankowski
authors: Rosebud O
authors: RO
authors: Roberts
authors: Toby N
authors: TN
authors: Weingarten
authors: Andrea L
authors: AL
authors: Aguilar
authors: Kayla J
authors: KJ
authors: Runkle
authors: Amanda K
authors: AK
authors: Tucker
authors: Kathryn C
authors: KC
authors: McLaren
authors: Darrell R
authors: DR
authors: Schroeder
authors: Andrew C
authors: AC
authors: Hanson
authors: David S
authors: DS
authors: Knopman
authors: Carmelina
authors: C
authors: Gurrieri
authors: David O
authors: DO
authors: Warner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology / Q000209:etiology; D000768:Anesthesia, General / Q000009:adverse effects*; D016022:Case-Control Studies; D003704:Dementia / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors
references: Neurology. 1988 Jun;38(6):975-80
references: 3368079
references: Anesthesiology. 2004 Sep;101(3):703-9
references: 15329595
references: Int J Epidemiol. 2001 Jun;30(3):590-7
references: 11416089
references: Neurology. 1991 Sep;41(9):1393-7
references: 1891088
references: BMC Geriatr. 2011 Dec 14;11:83
references: 22168260
references: Neurology. 1994 Nov;44(11):2073-80
references: 7969962
references: Arch Neurol. 2002 Oct;59(10):1589-93
references: 12374497
references: J Biomed Inform. 2009 Apr;42(2):377-81
references: 18929686
references: Lancet. 1998 Mar 21;351(9106):857-61
references: 9525362
references: N Engl J Med. 2011 Jun 9;364(23):2227-34
references: 21651394
references: Nat Rev Neurol. 2011 May 03;7(6):323-31
references: 21537355
references: Dement Geriatr Cogn Disord. 2010;29(3):233-9
references: 20375503
references: Am J Epidemiol. 2011 May 1;173(9):1059-68
references: 21430193
references: Age Ageing. 2006 Mar;35(2):154-60
references: 16414964
references: Acta Psychiatr Scand. 2010 Apr;121(4):241-2
references: 20419866
references: Neurology. 1992 Nov;42(11):2063-8
references: 1436513
references: Nutrition. 2005 Jun;21(6):775-7
references: 15925305
references: Arch Neurol. 2001 Apr;58(4):598-604
references: 11295990
references: Neurobiol Aging. 2008 Jul;29(7):1002-10
references: 17346857
references: Anesthesiology. 2007 Mar;106(3):572-90
references: 17325517
references: J Gerontol A Biol Sci Med Sci. 2006 Dec;61(12):1300-6
references: 17234824
references: Ann Neurol. 1984 Apr;15(4):335-41
references: 6742780
references: Eur J Pharmacol. 2006 Nov 7;549(1-3):71-8
references: 16979155
references: Am J Epidemiol. 1998 Jul 1;148(1):51-62
references: 9663404
references: N Engl J Med. 2001 Feb 8;344(6):395-402
references: 11172175
references: J Alzheimers Dis. 2010;22 Suppl 3:91-104
references: 20858967
references: Mayo Clin Proc. 2012 Dec;87(12):1202-13
references: 23199802
references: Psychiatry Res. 2012 Mar 30;196(1):90-5
references: 22390831
references: Sci Am. 1981 Oct;245(4):54-63
references: 7027437
references: J Neurosci. 2007 Feb 7;27(6):1247-54
references: 17287498
references: J Am Geriatr Soc. 1998 Oct;46(10):1258-65
references: 9777908
references: Mayo Clin Proc. 2011 Sep;86(9):885-93
references: 21878601
references: Mayo Clin Proc. 1996 Mar;71(3):266-74
references: 8594285
references: Eur J Anaesthesiol. 2012 Sep;29(9):409-22
references: 22828386
references: Alzheimer Dis Assoc Disord. 2003 Jul-Sep;17(3):139-45
references: 14512826
references: N Engl J Med. 2010 Jan 28;362(4):329-44
references: 20107219
references: J Alzheimers Dis. 2011;24(2):201-16
references: 21447878
references: Neurology. 2010 Jul 6;75(1):35-41
references: 20603483
references: Arch Neurol. 2006 Feb;63(2):218-21
references: 16476810
references: Neurology. 1986 Jul;36(7):922-31
references: 3714054
references: FASEB J. 2009 Aug;23(8):2595-604
references: 19279139
references: JAMA. 1995 Apr 26;273(16):1274-8
references: 7646655
references: Am J Epidemiol. 1985 Mar;121(3):414-21
references: 4014131
references: J Neurosci. 2007 Mar 21;27(12):3090-7
references: 17376970
references: Mayo Clin Proc. 2003 Oct;78(10):1290-308
references: 14531488
references: Mayo Clin Proc. 2012 Feb;87(2):151-60
references: 22305027
references: Mayo Clin Proc. 2012 Feb;87(2):120-9
references: 22305025
references: Neurology. 2007 Aug 21;69(8):739-46
references: 17709705
references: Acta Anaesthesiol Scand. 2003 Mar;47(3):260-6
references: 12648190
references: Int J Epidemiol. 2012 Dec;41(6):1614-24
references: 23159830
references: Neurology. 1984 Jul;34(7):939-44
references: 6610841
references: Ann Neurol. 2008 Dec;64(6):618-27
references: 19006075
references: Mayo Clin Proc. 1996 Mar;71(3):275-82
references: 8594286
references: Anaesthesia. 2010 Apr;65(4):388-95
references: 20136805
references: Mayo Clin Proc. 2006 Feb;81(2):223-30
references: 16471078
references: Neurol Sci. 2002 Apr;23(1):11-4
references: 12111615
references: Alzheimers Dement. 2011 Jan;7(1):53-60
references: 21255743
references: Alzheimer Dis Assoc Disord. 2006 Jul-Sep;20(3):141-6
references: 16917183
references: Anesthesiology. 2009 Apr;110(4):796-804
references: 19293700
references: J Am Geriatr Soc. 1994 Feb;42(2):198-201
references: 8126336
references: Alzheimers Dement. 2011 Jan;7(1):80-93
references: 21255746
references: Ann Neurol. 1990 Dec;28(6):766-74
references: 2285263
references: Arq Bras Cir Dig. 2012 Jan-Mar;25(1):49-51
references: 22569979
references: Neurology. 2005 Oct 11;65(7):986-90
references: 16217048
references: Anesth Analg. 2003 Apr;96(4):1004-1009
references: 12651650
references: Exp Gerontol. 2006 Apr;41(4):346-59
references: 16564662
references: Alzheimers Dement. 2011 May;7(3):263-9
references: 21514250
references: Neurology. 1990 Nov;40(11):1698-707
references: 2146525
references: Proc Natl Acad Sci U S A. 2010 Nov 23;107(47):20518-22
references: 21041647
references: Masui. 2009 Mar;58(3):308-14
references: 19306631
references: Anesth Analg. 2005 Nov;101(5):1389-1392
references: 16243999
references: Neurology. 1992 Aug;42(8):1481-8
references: 1641140