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Tuesday, 03 July 2018 08:00

Delirium and dementia – is anaesthesia safe?

While delirium and dementia share very similar symptoms, they are completely different conditions which are commonly confused with each other. Likewise, the cause of these conditions is very different – but what they do have in common is that going under the knife with general anaesthesia can exacerbate both of their symptoms.

Common symptoms of both delirium and dementia include confusion, issues with perceptions, mood swings and impaired cognition, however they are separated by the length of time they affect the elderly.

Delirium is often characterised by short, abrupt disruptions in mental cognition and function, while dementia is indicated by a gradual decline in mental function over time. People with dementia can often show signs of delirium and vice versa. However, these two conditions are vastly different.

Delirium and anaesthesia

Delirium, brought on by anaesthesia, can be a fairly common occurrence in the elderly who undergo surgery and hospitalisation. In fact, this has led to studies aimed at whether anaesthesia can cause permanent brain damage or even drive the onset of dementia. However, results have been inconclusive, with no real body of evidence to prove either of these theories. At present, post-operative cognitive dysfunction (POCD) is the terminology used to describe a specific decline in cognitive ability post-anaesthesia.

Is anaesthesia safe for those with dementia?

As a caregiver you may be faced with a big decision when it comes to a loved one needing surgery which requires full anaesthesia. The truth is that the risks associated with anaesthesia and dementia still remain a little blurry, some seniors make a full recovery without any further cognitive decline, while others never return to their pre-cognitive ability.

When it comes time to make such a decision, here are some important thoughts to consider and steps to take:

1. Consider the benefits of the surgery on their future quality of life. Will the surgery help to drastically improve mobility, pain levels or a loved one’s overall health? Do the pros outweigh the cons?
2. When making the decision, take into account their age, physical health and pre-existing cognitive abilities. Is their level of dementia just too advanced to risk any further cognitive decline, or do the benefits of surgery outweigh the risks?
3. Consider their ability to co-operate, participate and understand post-op rehabilitation, if it’s needed.
4. Meet with their doctors and consider whether full anaesthesia is needed for a procedure. Regional anaesthesia in combination with a sedative can also be a safe and effective alternative to reduce the risks posed by full anaesthesia.
5. Make sure that a full pre-op evaluation with their existing physician is done, and make that surgeons and anaesthesiologists are aware of their medication regimen and any pre-existing conditions i.e. dementia, heart or lung conditions, hypertension, diabetes etc.  

No matter your age there are always risks associated with undergoing anaesthesia, and when it comes to the elderly, preparation and evaluation is key. Ensuring the medical team is up-to-date on your loved one’s health status will always decrease the risk of anything going wrong!

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