Major Surgery Doubles Risk Of Substantial Brain Decline, Study Suggests

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SOURCE: Study: Having major surgery doubles your risk of substantial mental decline | Canada.com

Major surgery doubles the chance of experiencing a substantial decline in mental skills, including reasoning, memory and language ability, a study suggests.

Doctors and scientists have long feared that general anaesthetic, mini-strokes or inflammation may damage the brain during surgery, but there has been little evidence to demonstrate a long-term impact.

Now a longitudinal study of more than 7,000 British civil servants, who were tested between 1997-2016, has found that those who underwent major operations were twice as likely to suffer substantial cognitive decline than those who did not have surgery.

Although the research did not cover dementia, cognitive decline can precede or speed up its development because of a reduction in brain resilience.

While the study, published in the BMJ, showed around one in 40 people suffered a significant reduction in mental ability during the 19-year follow-up period, the number rose to more than one in 18 for those who had a major operation. Major surgery was also found to age the brain by an average of four months and three days.

Researchers from the University of Wisconsin said it was unclear whether the effect was driven by the operation itself, or the underlying medical condition that had necessitated the surgery.

However, they said patients should be warned of the potential for damage when discussing a future operation.

“The cognitive effects of surgery should be considered alongside the other potential health benefits,” said Robert Sanders, an assistant professor.

“Potential mechanisms” of brain injury during the surgery process included strokes, mini-strokes and inflammation, while “long-term cognitive health” may also be influenced by postoperative pain and some medications, he added.

Researchers examined data from 7,532 men and women recruited from the Civil Service in London between 1985-88. From 1997, a battery of tests — repeated four times until 2016 — monitored their mental ability.

During that 19-year period, 1,250 were admitted to hospital for major surgery, and after accounting for age-related cognitive decline, the authors calculated that this was associated with brain ageing of just over four months.

Being admitted for a medical condition, such as a heart attack, led to a mental decline of 1.4 years, while a stroke aged the brain by 13 years.

Fiona Carragher, the chief policy and research officer at the Alzheimer’s Society, said: “Hospital admissions and the state of delirium that can result from extended stays can have a negative impact on cognition among people with dementia.

“(This study) points towards the importance of considering cognitive health during hospital admissions. Our own researchers are hard at work (on) solutions and training programmes.”
 
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