Prolonged Anesthesia Exposure Linked to Cognitive Decline

TOPLINE:

Increased exposure to general anesthesia during surgical procedures is associated with long-term decline in executive function, selective attention and mental speed, and information processing speed.

METHODOLOGY:

• In a sub-analysis of a prospective cohort study conducted in the Netherlands, researchers assessed the relationship between total exposure to general anesthesia and cognitive function over a follow-up period of 12 years.
• They included 1823 adults (mean age, 51.1 years; 50.1% men) without psychiatric or neurologic conditions who self-reported their surgical history, including the number and types of surgeries, during the baseline assessment.
• The duration of the reported procedures was projected by an experienced anesthesiologist, and the total time under general anesthesia was estimated using the midpoint of categorized durations: 3 hours (mean, 82.56 minutes).
• The impact of exposure to general anesthesia on cognitive domains such as verbal memory, selective attention and mental speed, executive function, and information processing speed was assessed using various tests.
• Psychologists or trained assistants performed neuropsychological tests such as the Stroop Color Word Test and the Concept Shifting Test to measure the cognitive domains at baseline, 6 years (n = 1417), and 12 years (n = 1188).

TAKEAWAY:

• Increased exposure to general anesthesia at baseline was associated with a decline in executive functioning (P P P
• A negative effect on all cognitive domains was associated with older age and a lower level of education.
• Health-related factors such as hypertension, diabetes, and smoking also negatively affected cognitive domains, such as executive function, selective attention and mental speed, and information processing speed.

IN PRACTICE:

“Our study indicates that prolonged exposure to surgery under general anaesthesia during an individual’s lifetime significantly affects long-term cognitive decline,” the authors of the study wrote. “Lifestyle management and prevention remain crucial for promoting healthy cognitive ageing and could play a significant role in managing the ageing surgical population,” they added.

SOURCE:

This study was led by Christoph H. Pennings, of the Maastricht University Medical Center in Maastricht, the Netherlands. It was published online on February 18, 2025, in European Journal of Anaesthesiology.

LIMITATIONS:

For surgical history, this study relied on patient-reported data that were collected only at baseline. Data on intra- or postoperative complications were not available, which may have affected the anesthesia exposure estimates. The use of historical data on the duration of the procedures may not reflect modern perioperative practices. The differences in the types of anesthesia, including the transition to total intravenous anesthesia, were not considered.

DISCLOSURES:

This study did not receive any specific funding. The authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.