Influence of Previous General Anesthesia on Cognitive Impairment: An Observational Study Among 151 Patients
Open Access
- 16 May 2022
- journal article
- research article
- Published by Frontiers Media SA in Frontiers in Human Neuroscience
- Vol. 16, 810046
- https://doi.org/10.3389/fnhum.2022.810046
Abstract
Introduction: Preoperative neurocognitive disorder (preO-NCD) is a common condition affecting 14–51. 7% of the elderly population. General anesthesia has already been associated with the one-year post-operative neurocognitive disorder (PostO-NCD), specifically, a deficit in executive function, measured by the Trail Making Test B (TMT-B), but its long-term effects on cognitive function have not been investigated. We aimed to detect preO-NCD prevalence in patients scheduled for cardiac surgery and further investigate the possible role of previous general anesthesia (pGA) in general preoperative cognitive status [measured via the Montreal Cognitive Assessment (MoCA)] and/or in executive functioning (measured via TMT-B). Methods: In this observational, prospective study, 151 adult patients scheduled for elective cardiac surgery underwent MoCA and TMT-B. Data on age, education, pGA, comorbidities, and laboratory results were collected. Results: We discovered a general cognitive function impairment of 79.5% and an executive function impairment of 22%. Aging is associated with an increased likelihood (OR 2.99, p = 0.047) and education with a decreased likelihood (OR 0.35, p = 0.0045) of general cognitive impairment, but only education was significantly associated with a decreased likelihood (OR 0.22, p = 0.021) of executive function impairment. While pGA did not significantly affect preO-NCD, a noteworthy interaction between aging and pGA was found, resulting in a synergistic effect, increasing the likelihood of executive function impairment (OR 9.740, p = 0.0174). Conclusion: We found a high prevalence of preO-NCD in patients scheduled for cardiac surgery. General cognitive function impairment is highly associated with advancing age (not pGA). However, older patients with at least one pGA appeared to be at an increased risk of preO-NCD, especially executive function impairment, suggesting that TMT-B should be associated with MoCA in the preoperative cognitive evaluation in this population.Keywords
Funding Information
- Università degli Studi di Padova
This publication has 63 references indexed in Scilit:
- Mechanistic Insights into Neurotoxicity Induced by Anesthetics in the Developing BrainInternational Journal of Molecular Sciences, 2012
- Sleep-Disordered Breathing, Hypoxia, and Risk of Mild Cognitive Impairment and Dementia in Older WomenJAMA, 2011
- Preoperative Cognitive Assessment of the Elderly Surgical PatientAnesthesiology, 2011
- Ketamine anesthesia during the first week of life can cause long-lasting cognitive deficits in rhesus monkeysNeurotoxicology and Teratology, 2011
- Long-term Cognitive Impairment and Functional Disability Among Survivors of Severe SepsisJAMA, 2010
- Prevalence of mild cognitive impairment is higher in menNeurology, 2010
- Anesthetic Sevoflurane Causes Neurotoxicity Differently in Neonatal Naïve and Alzheimer Disease Transgenic MiceAnesthesiology, 2010
- Progression of Mild Cognitive Impairment to Dementia in Clinic- vs Community-Based CohortsArchives of Neurology, 2009
- Derivation and Validation of a Preoperative Prediction Rule for Delirium After Cardiac SurgeryCirculation, 2009
- Hypertension and the Risk of Mild Cognitive ImpairmentArchives of Neurology, 2007