Risk of Dementia in Patients Who Underwent Surgery under Neuraxial Anesthesia: A Nationwide Cohort Study

Abstract

The incidence of dementia in patients with surgery under neuraxial anesthesia and the possibility of surgery under neuraxial anesthesia as a risk factor for dementia were investigated. We performed a retrospective matched cohort study with nationwide, representative cohort sample data of the Korean National Health Insurance Service in South Korea between 1 January 2003, and 31 December 2004. The participants were divided into control (n = 4488) and neuraxial groups (n = 1122) using propensity score matching. After 9 years of follow-up, the corresponding incidences of dementia were 11.5 and 14.8 cases per 1000 person-years. The risk of dementia in the surgery under neuraxial group was 1.44-fold higher (95% confidence interval [95%CI], 1.17–1.76) than that in the control group. In the subgroup analysis of dementia, the risk of Alzheimer’s disease in those who underwent surgery under neuraxial anesthesia was 1.48-fold higher (95%CI, 1.17–1.87) than that in those who did not undergo surgery under anesthesia. Our findings suggest that patients who underwent surgery under neuraxial anesthesia had a higher risk of dementia and Alzheimer’s disease than those who did not undergo surgery under neuraxial anesthesia.

Comparison of regional vs. general anesthesia on the risk of dementia: a systematic review and meta-analysis

“…The characteristics of studies including age, gender distribution, sample size, study design, maximum follow-up duration, and country are summarized in Table 1 . The populations in the eligible studies included individuals aged 50 years and above ( 14 ), 55 years and above ( 19 ), 58 years and above ( 15 ), 65 years and above ( 17 ), 66 years and older ( 22 ), female patients aged ≥30 years undergoing hysterectomy ( 18 ), patients who received elective hip fracture surgery ( 20 ), and patients who underwent major elective surgery ( 21 ). The sample sizes varied widely, ranging from 877 to 280,308.…”

“…The proportion of males in each study varied between zero and 49.5%. Regarding study design, there were five population-based studies ( 14 , 18 , 20–22 ), one cohort study ( 19 ), one case–control study ( 15 ), and one prospective study ( 17 ). The maximum follow-up period ranged from 5 to 20 years.…”

“…The maximum follow-up period ranged from 5 to 20 years. The studies were conducted in various countries, including the United States ( 17 ), Taiwan ( 14 , 18 , 20 , 21 ), Korea ( 19 ), and Canada ( 22 ).…”

“…After removing duplicates (n = 34) and conducting title and abstract screening, 17 reports were assessed for eligibility. After further exclusion of nine studies based on full-text review due to not performing RA (n = 5), not reporting relevant outcomes (n = 3), and being a conference abstract (n = 1), eight cohort studies published between 2014 and 2023 were included in the final review (14,15,(17)(18)(19)(20)(21)(22).…”

Could Mid- to Late-Onset Glaucoma Be Associated with an Increased Risk of Incident Dementia? A Nationwide Retrospective Cohort Study

“…Parkinson’s disease is most commonly known for affecting function and movement, though it also affects cognition, particularly as the disease progresses. It is a neurodegenerative disorder of the brain, such as Alzheimer’s disease, and also has similar neurotoxic substances and vascular risk factors [ 19 , 20 , 21 ]. However, prior studies showed no association between POAG and Parkinson’s disease during the follow-up period [ 5 , 22 ].…”