Risk of dementia in older patients with different anesthesia: a systematic review and meta-analysis of cohort studies
Bibliographic record
Abstract
BACKGROUND: Anesthesia has been hypothesized to influence dementia risk due to its potential neurotoxic effects, especially in older patients. The administration of anesthetic agents may exacerbate underlying neurodegenerative processes. This study aimed to assess the risk of dementia, Alzheimer’s disease (AD), and Alzheimer’s disease and related dementia (ADRD) in older patients who underwent general or regional anesthesia. METHODS: We conducted a systematic review and meta-analysis to explore the associations between different types of anesthesia and the risk of dementia, AD, and ADRD in older patients. We searched Cochrane Library, PubMed, Web of Science, and EMBASE databases from inception to 13, February 2025. Two authors independently selected eligible studies, used the Newcastle-Ottawa Scale to assess the quality of included studies, and extracted data. Any disagreements were resolved through discussions involving a third author. RESULTS: Eight population-based cohort studies were included and considered as high quality. Our findings indicated that the type of anesthesia (general or regional) did not increase the risk of dementia (hazard ratio [HR] 1.30, 95% confidence interval [CI] 0.85–2.00), AD (HR 0.83, 95% CI 0.55–1.25),ADRD (HR 0.95, 95% CI 0.84–1.08), or composite outcome dementia (HR 1.17, 95% CI 0.90–1.52). We also found no increase in the risk of dementia (HR 1.33, 95% CI 0.30–5.94), AD (HR 0.83, 95% CI 0.55–1.25, or composite outcome dementia (HR 1.06, 95% CI 0.72–1.56) among older patients underwent general anesthesia. In the stratified analysis, we found differences between male and female in terms of increased risk of dementia, AD or ADRD (HR 0.89, 95% CI 0.82–0.96).We also found no increase in dementia, AD or ADRD among older patients exposed to different anesthesia protocols between Asia and North America. CONCLUSIONS: The available limited, low-quality evidence does not indicate an increased risk of dementia in older patients exposed to general or regional anesthesia. However, it is necessary to acknowledge that anesthesia may influence cognitive function.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.015 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".