anesthesia causing dementia?

[brit1]

My cardiologist has suggested I may want to get an ablation for my AF. However altho otherwise in great health/slim/fit/vegan I am concerned because I am 84 and have read that anesthesia can contribute to dementia in elderly patients. As my husband had dementia I know that is the last thing I would want to get i

[CDreamer]

Hi

You don’t need anaesthesia to have an ablation, some do but most are done under sedation. You would need to speak with your doctor.

We are in the UK and worth noting one observation - in US hospitals are more likely to push ablation because it generates income. In UK, because resources are scarcer and because surgeons are not paid per each procedure but receive a salary, there tends to be a more considered approach.

Basically the evidence for this is mixed but the general note is that the older the patient, the higher the risk - but of course this doesn’t take into account other factors such as general health and fitness. This is what the Alzheimer’s Association say:- alzheimers.org.uk/about-dem...

How desperate are you to be rid of the AF, which in itself can be a risk factor for developing dementia? mediated by taking anticoagulants of course! If the AF doesn’t trouble you much and you are otherwise fit and well, my view would be why have an invasive procedure with no guarantees it will keep you out of AF permanently, with a recovery period which can vary? Ablation is not a cure for AF, although it works well for many people, whilst others find they need multiple ablations or other procedures.

You don’t say if your AF is paroxysmal or persistent? This will be a factor on the likely outcome of a successful ablation. I had 2 in my ‘60’s for very symptomatic AF and AF returned some 3 years later.

If you are very symptomatic with AF and it is seriously affecting your quality of life then I would at least go to the next stage and research more to see if you would be a likely candidate for a successful ablation. Here is the link to the AA information on AF ablations

heartrhythmalliance.org/aa/...

Hope some of that helps. Best wishes.

[jedimasterlincoln in reply to CDreamer]

Great reply as always.

[RussJun55 in reply to CDreamer]

You may be right about many US hospitals but what I've encountered with 3 systems in the Boston area is they're pretty conservative about recommending ablations for AF,

[Ppiman]

I recall reading of this association many years ago but more recently have read that it isn't the case at all, only that some cognitive issues can occur after surgery with GA, but that these are entirely temporary.

There's plenty online about this.

Steve

[jedimasterlincoln in reply to Ppiman]

Yep. Post operative delirium in older patients is quite common. More is said about it now than ever used to be.

[Ppiman in reply to jedimasterlincoln]

I recall reading once that each GA we receive in life reduces our cognitive ability cumulatively. But now they know it doesn't. It just shows how these things can be wrong even from peer reviewed top sources.

Steve

[BobD Volunteer in reply to Ppiman]

Every fact has a finite life Steve. Except that one.

The earth is flat still isn't it and the sun revolves around the earth?

[Ppiman in reply to BobD]

Indeed. Ask my brother and his mate, Bob, who are fully paid up members of the David Icke Flat Earth Society. Since covid it's become much worse to the point that conversation is constantly twisted towards some weird idea and I have to bite my lip.

It's a strange old word since social media took over some people's lives.

Steve

[Auriculaire in reply to Ppiman]

I thought David Icke was the take over by the lizard people proponent.

[Ppiman in reply to Auriculaire]

That’s the fellow (or is he a shapeshifting reptilian humanoid?).

Steve

[Tryfan]

Whilst I can't add anything to CD dreamer erudite and thoughtful response. From a purely observational view. My Father was never the same after a Prostate operation in his mid 70's. Alzheimer being a major factor.

[mjames1]

A legitimate concern although the ep's I've talked to brush it off. Personally, I would find someone who does conscious sedation. I think that's quite common in your part of the world. Unfortunately in the US, almost all ep's use GA for afib ablations.

Jim

[Tapanac]

Well unfortunately I’ve had so many many operations ranging from a couple of hours GA to eleven and half hours. Touch wood still with it although like most elderly people cannot always remember odd things like who sang what and now what did I come upstairs for. No one has ever told me that GA can cause dementia

My husband has mild dementia and he has never had a GA

I was told many years ago that each time one had a GA it can harden the lungs a tiny bit, but have never noticed that

Don’t worry you will be fine

Pat

[theohappy in reply to Tapanac]

Hmmm, that’s interesting! I’m going to ask the pulmonologist I see tomorrow about that. I’ve had six surgeries this past year. Now having problems with my lungs. Maybe a connection.

[Buffafly]

I’ve read recently that it’s only lately that anaesthetists have picked up on Post Operative Cognition Dysfunction so that’s the opposite of what Ppiman is saying. Personally I wouldn’t have another GA unless I had to and I’m 77 but I have lung problems. I don’t think one GA would cause dementia on its own especially as the anaesthetic for an ablation wouldn’t need to be very deep? I understand the worry about dementia as my husband has it but that was from an operation that nearly killed him and the effect of small strokes, I couldn’t blame the GA.

[jwsonoma]

Anecdotal: I was told by a doctor regarding my 87 yr old mother's delerium that age is an overwhelming factor in recovering. He was refering to her on going slightly reduced mental capacity from a fever. I was told that as you get older you don't fully bounce back to your preincident mental capacity. I think the short fall is based on an individual's personal factors and fitness.

I also agree that here in the US there can be a huge conflict of interest. Surgeons don't get paid if they don't do the procedure. If there is any doubt that the procedure isn't absolutley necessary I would get an uncomprimised decision. Maybe a second opinion from a specialist who doesn't do surgery.

[lovetogarden]

Check with the dr to see what he uses during the procedure. I was surprised to read my ablation notes and find that I’d had conscious sedation. Sure was effective! I certainly didn’t remember a thing and felt fine by the end of the day. No nausea or fogginess. (I’m also in the US)

[Samazeuilh2]

I read that the length of the time you are under the anaesthesia matters a lot. If your procedure is a fairly quick one-say an hour- there is less likely to be a problem than if it runs for five hours. Of course, it may not be possible to determine the duration in advance. You could consider not have an anaesthetic. There might also be less problematic types of anaesthesia which you could discuss.