The Risk of Dementia after Anesthesia Differs according to the Mode of Anesthesia and Individual Anesthetic Agent
Seung-Hoon Lee1,2, Won Seok William Hyung1,2, Surin Seo1,2, Junhyung Kim1,2, Changsu Han1,2, Kwang-Yeon Choi3, HyunChul Youn4, Hyun-Ghang Jeong1,2
1Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
2Korea University Research Institute of Mental Health, Seoul, Korea
3Department of Psychiatry, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
4Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
Correspondence to: Hyun-Ghang Jeong
Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea
E-mail: jeonghg@korea.ac.kr
ORCID: https://orcid.org/0000-0002-0318-5069
Received: February 17, 2024; Revised: March 15, 2024; Accepted: March 16, 2024; Published online: June 4, 2024.
© The Korean College of Neuropsychopharmacology. All rights reserved.

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Abstract
Objective: 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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