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Is Surgery Linked to Cognitive Decline?

There have been contradictory reports that undergoing surgery reduces cognitive function in Alzheimer’s patients. The findings of a new study published in the journal, Anesthesiology, challenge the widely held belief that elderly patients suffer major deterioration in mental function after surgery especially, when they go under general anesthesia.

"The concerns surrounding postoperative cognitive decline following surgery certainly will not evaporate following publication of this study," claims Michael S. Avidan of the Washington University School of Medicine. "The important message to take from these findings is that persistent cognitive deterioration following surgery might not be a major public health problem. The decision to proceed with surgery should presently be made based on a person's general health and the specific risks and benefits of the procedure."
While having read this study carefully, I am personally not convinced because of anecdotal evidence. When my father who had Alzheimer’s went under general anesthesia for a surgical procedure for an enlarged prostate, I was amazed at his decline post-surgery. It wasn’t just because he was in a hospital setting with strangers. This would be quite understandable. However, his confusion continued at home and he never improved; he stood on a lower rung of functioning.

Then when my mother got Alzheimer’s and she needed hip surgery, I by no means let her have general anesthesia to the great chagrin of the anesthesiologist. “How will I calm her down; I can’t reason with her,” he argued. I stood my ground and countered with, “You can give her a mild tranquilizer. You can give her a shot of whiskey as far as I am concerned, but under no circumstances will you put her under and if you do, I will know as soon as you wheel her into recovery.” My mother didn’t get general anesthesia and post-surgery possessed the same level of cognitive function as pre-surgery. The resident working on her case called me over and applauded my advocacy. He confided, “My father has Alzheimer’s and I noted that after general anesthesia, he was never the same. I don’t know why this is so, but somehow there is a link.” I can tell you a few more similar stories, but why repeat the same plot.

The take home message is that you need to make an aware choice, based on the science and the story. Also, the physical health risk, the need for surgery, might override the fear of hastened cognitive decline.
For more information on caregiving read my book, Changing Habits: The Caregivers' Total Workout. To listen to archived radio shows with guest experts visit Turn On Your Inner Light Radio Show




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