Exp Gerontol. 2022 May 4:111830. doi: 10.1016/j.exger.2022.111830. Online ahead of print.
ABSTRACT
BACKGROUND: We hypothesized that cumulative anesthesia exposure over the course of routine treatment of colorectal cancer in older adults can increase long-term risk of Alzheimer’s disease (AD), Alzheimer’s disease-related dementias (ADRD) and other chronic neurocognitive disorders (CND).
METHODS: We conducted a SEER-Medicare-based retrospective cohort study of 84,770 individuals age 65 years and older diagnosed with colorectal cancer between 1998 and 2007 using a proportional hazards model with inverse probability weighted estimators. The primary exploratory variable was a time-variant measure of cumulative anesthesia exposure for abdominal and pelvic procedures, updated continuously.
RESULTS: Our primary outcomes, AD and ADRD, occurred in 6005/84,770 (7.1%) and 14,414/83,444 (17.3%) individuals respectively. No statistically significant association was found between cumulative anesthesia exposure and AD (hazard ratio [HR]:0.99; 95% CI, 0.97-1.01). However, it was moderately associated with the risk of ADRD (HR, 1.02; 95% CI, 1.004-1.03) and some secondary outcomes including most notably: cerebral degeneration (HR, 1.05; 95% CI, 1.03-1.06), hepatic encephalopathy (HR, 1.13; 95% CI, 1.10-1.17), encephalopathy-not elsewhere classified (HR,1.10; 95% CI: 1.08-1.12), and incident/perioperative delirium (HR, 1.02; 95% CI, 1.01-1.03). Furthermore, we observed an association between cumulative anesthesia exposure and incident/perioperative delirium (HR, 1.06; 95% CI, 1.04-1.08), with perioperative delirium being associated with increased AD risk (HR, 2.05; 95% CI, 1.92-2.09).
CONCLUSION: Cumulative anesthesia exposure for abdominal and pelvic procedures was not associated with increased risk of AD directly and had a small but statistically significant association with ADRD, and a number of other CNDs. Cumulative anesthesia exposure was also associated with perioperative delirium, which had an independent adverse association with AD risk.
PMID:35525395 | DOI:10.1016/j.exger.2022.111830
