Older persons should think twice about surgery.

Older patients who undergo anesthesia and surgery have a significantly increased risk for dementia. Researchers in a British Journal of Psychiatry study found that patients older than 50 years who underwent anesthesia for the first time had nearly a 2-fold increased risk for dementia, mainly Alzheimer's disease, compared with nonanesthetized patients.

The researchers stated that anesthesia and surgery are inseparable in clinical settings. Thus, it is difficult to establish whether the increased risk of dementia development they observed was attributable to the anesthesia per se, the surgical process, or both.

The study included 24,901 patients aged 50 years and older who were anesthetized for the first time since 1995 between January 1, 2004, and December 31, 2007, and a control group of 110,972 randomly selected age- and sex-matched patients. All participants were followed until December 31, 2010, to identify the emergence of dementia.

There is growing concern that anesthetic drugs may have neurodegenerative complications. Two previous in vivo studies and imaging studies have shown that inhaled anesthetic agents can promote amyloid β peptide (Aβ) peptide oligomerisation and enhance Aβ-induced neurotoxicity. Other potential mechanisms of anesthetic-induced neurotoxicity include calcium dysregulation..