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Exposure to anaesthetic agents, cognitive functioning and depressive symptomatology in the elderly

GUILHEM DE ROQUEFEUIL, BSc, BERNARD LEDÉSERT, MD and KAREN RITCHIE, PhD

INSERM EPI-9930, Montpellier

FRANÇOIS BONNEL, MD and JEAN-CLAUDE CHEMINAL, MD

Service d'Orhtopédie III, Hôpital Lapeyronie, Montpellier, France

Correspondence: Dr Marie L. Ancelin, INSERM EPI-9930, Epidemiology and Clinical Research in Nervous System Pathologies, CRLC Val d'Aurelle, Bat. Rech. Rdc, Parc Euromédecine, 34298 Montpellier Cedex 5, France

Declaration of interest None. Funding detailed in Acknowledgements.

Background Anaesthesia could provoke persistent alterations in specific cognitive domains in the elderly where ageing-related neuronal changes may exacerbate pharmacotoxic effects.

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

Method 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.

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