The risk of dementia after anesthesia differs according to the mode of anesthesia and individual anesthetic agent
Seung-Hoon Lee 1, 2, Won Seok William Hyung 1, Surin Seo 1, Changsu Han 1, 2, Junhyung Kim 1, 2, Kwang-Yeon Choi 3, HyunChul Youn 4, Hyun-Ghang Jeong 1, 2*
1Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea, 2Korea University Research Institute of Mental Health, Seoul, Republic of Korea, 3Department of Psychiatry, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea, 4Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
Received: February 17, 2024; Revised: March 15, 2024; Accepted: March 16, 2024; Published online: March 16, 2024.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Background: Multiple cohort studies have investigated the potential link between anesthesia and dementia. However, mixed findings necessitate closer examination. This study aimed to investigate the association between anesthesia exposure and the incidence of dementia, considering different anesthesia types and anesthetic agents.
Methods: This nationwide cohort study utilized data from the South Korean Health Insurance Review and Assessment Service database, covering 62,541 participants, to investigate the correlation between anesthesia exposure and dementia incidence.
Results: Results revealed an increased risk of dementia in individuals who underwent general (hazard ratio (HR): 1.318; 95% confidence interval (CI): 1.061–1.637) or regional/local anesthesia (HR: 2.097; 95% CI: 1.887–2.329) compared to those who did not. However, combined general and regional/local anesthesia did not significantly increase dementia risk (HR:1.097; 95% CI: 0.937-1.284). Notably, individual anesthetic agents exhibited varying risks; desflurane and midazolam showed increased risks, whereas propofol showed no significant difference.
Conclusion: This study provides unique insights into the nuanced relationship between anesthesia, individual anesthetic agents, and the incidence of dementia. While confirming a general association between anesthesia exposure and dementia risk, this study also emphasizes the importance of considering specific agents. These findings under-score the need for careful evaluation and long-term cognitive monitoring after anesthesia
Keywords: Dementia, Anesthesia, Postoperative complications, Postoperative Cognitive Complications, Cohort Studies, Incidence


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