Anesthetics and Alzheimer's disease

IOS Press ^ | November 12, 2010 | Unknown

[decimon]

First inclusive report published in Journal of Alzheimer's Disease

Amsterdam, The Netherlands and San Antonio, TX, USA, November 12, 2010 – There is growing global concern regarding the potential neurotoxicity of anesthetics. Biophysical and animal model studies have identified molecular changes simulating Alzheimer's disease (AD) pathology after exposure to inhaled anesthetics. This research has alerted anesthesiologists, neuropsychologists, surgeons and other clinicians to initiate in-depth clinical research on the role of anesthetics in post operative cognitive decline.

AD is a devastating disease commonly found in elderly persons and an enormous world health problem. It is manifested by severe memory loss, language problems, impaired decision making and affected activities of daily living. The human population is aging with increase in life expectancy. Therefore, we are confronted with increases in the number of persons at risk of developing AD and also the number of elderly undergoing surgical procedures. Any possible association between the two therefore merits careful consideration.

In the absence of either a single coherent etiological model to explain the cause of AD or an effective treatment, a consistent part of funding for research in AD is currently aimed at identifying risk factors as well as delaying the clinical manifestations of the disease. Recent research has focused on reduction of disease incidence through identification of risk factors. In this context the question of the association between AD and anesthesia has again been raised.

A supplement to the Journal of Alzheimer's Disease on "Anesthetics and Alzheimer's Disease" provides the platform to bring the latest scientific studies to the AD research and clinical communities. Leading scientist and guest Editors Dr. Pravat K Mandal from the National Brain Research Centre, a world class neuroscience centre located in India, and Dr. Vincenzo Fodale from the University of Messina, Italy, a university recognized globally for advanced research, have brought together the latest research results from scientists, neurologists, physicians, neuropsychologists, and anesthesiologists on various aspects of the pathophysiology of AD and the role of anesthetics as a possible risk factor.

Highlights of special issue are:

* Cellular and molecular pathology in AD

* Influence of anesthetic size on Aβ oligomerization established using state-of-the-art NMR spectroscopic technique (a fundamental contribution in this area of research)

* Evidence from animal model studies indicating more plaque formation in transgenic mice treated with inhaled anesthetics like halothane or isoflurane

* Association between impairment of cholinergic neurons and cognitive deficits in AD patients; and the possible role of anesthetics in cholinergic dysfunction

* Multifactorial etiology, including the type of anesthesia, apolipoprotein E genotype, and the presence of co-morbid disorders, in the development of long-term post-operative cognitive decline

* Anesthesia in patients with dementia; noteworthy clinical antecedents and peri-operative risk management in AD

Guest Editors Drs. Mandal and Fodale emphasized that "this special issue is a cornerstone in the effort to update and clarify the possible linkages between common anesthetics given to millions of patients every day and the pathomechanism of AD, thus contributing to an ongoing constructive debate. The Editors of the supplement do not intend to engender a 'fear of anesthesia' that could lead to irrational rejection of surgery in later life, but they hope to encourage the earnest quest for the 'safe anesthetic' for the elderly and more research are warranted."

Dr. Mandal stated that "the publication of this issue is most timely and it will add value, depth, and advancement to the current scientific knowledge in this area."

[decimon]

Ping

[Steely Tom]

The eyes of every tort lawyer in the country just bugged out, as if on a single command from the mother wheel.

[La Lydia]

All this time I thought it was aluminum coffee pots.

[2 Kool 2 Be 4-Gotten]

I used to know what caused it but I forgot.

[Robwin]

Am I the only person who wonders if flouridation of the water supply has played a role in the explosion of this disease?

[Inyo-Mono]

BTTT

[anniegetyourgun]

I have long suspected a connection. I’m avoiding surgeries at all costs...and won’t be doing anything elective.

[norwaypinesavage]

Both of my parents died in the last several years from AD. Both had MAJOR reductions in mental ability directly following anesthesia. I noticed it at the time and mentioned it to the doctor. He dismissed my observation and said there was NO effect. My Dad fell and broke his pelvis. While he was hospitalized, my Mom died. He was fully functional before the fall. Afterward, he never even knew she died though he was told it many times.

[RonInNaples]

Oh oh, looks like the guys and I from high school biology class need to check out each other and all our girlfriends from the time. We used ether on cotton balls to put fruit flies to sleep for cross-breeding. High school boys + ether. What do you think happened? OK, to our credit nobody ever went all the way under. We’d catch them before they fell and remove the cotton we were holding to their nose. Went through a LOT of ether in that class...

[FrdmLvr]

I thought they already knew that for a long time now. My mom’s always been very wary of elective surgeries and anesthesia for that reason.

[surroundedbyblue]

So what’s the alternative? Bite a bullet?

Seriously, there are many reasons for post-op decline. Yes, we know that the drugs do play some part but as I said, there are MANY reasons for this phenomenon

[Guenevere]

bttt

[RightGeek]

Maybe intravenous anesthetics?

[ErnBatavia]

Yes....I personally think that the human body wasn't engineered to live as long as we are now. My mother developed Alzheimers in what I'd call a "rapid onset" mode....for no reason whatsoever - no surgery, no chewing on aluminum....nothing (other than hitting her mid-80's).

It's a devastating condition - and I kinda muse that AD is a catch-all for many dementia syndromes.

[decimon]

So what’s the alternative?

Maybe intravenous anesthetics?

The article specifies inhaled anesthetics so intravenous anesthetics may be right. Or local anesthetics. But that's above my bray grade as I'm not any sort of medico.

[Zuben Elgenubi]

The eyes of every tort lawyer in the country just bugged out, as if on a single command from the mother wheel.

Well said. Full marks.

[ExTexasRedhead]

Most doctors deny side effects to everything. Go to www.askapatient.com and find out all the side effects to the drugs you’re taking. The common thread to most of the complaints is “my doctor blew me off.”

[ottbmare]

Not all surgeries have to involve inhaled anesthetics. You can do a lot of procedures with some Versed and Fentanyl. I mean obviously not open-heart surgery, but a lot of stuff that doesn’t involve opening you up like a mackerel.

[OldEagle]

Is this what is called “bubble head”?