Can MAC anesthesia for cataract surgery accelerate dementia? - AgingCare.com

Can MAC anesthesia for cataract surgery accelerate dementia?

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My mother had 3 eye surgeries within 7 months. With each one I saw a mild cognitive decline but thought it was due to poor sight. It became so bad we had her evaluated and she was diagnosed with dementia. In 2 months after being started on aricept and namenda she literally cannot perform any adl's, cries all day and has declined to the point of memory care facility. No one will say whether the heavy sedation accelerated or caused the dementia or if the med are making her worse everyone keeps saying dementia can progress very rapidly. We have taken her off ALZ mess to see if she regains any functionality against her neurologist recommendations any ideas or suggestions

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Researchers claim that dementia shows up in the brain years before symptoms appear. I think we can pretty much assume the eye surgeries did not cause the dementia, which has been present with no symptoms showing for years.

Did the surgical experiences trigger the appearance of the dementia? And if so, how much longer could it have remained unsymptomatic if she hadn't had the surgery? I don't think at our present state of scientific knowledge we can answer those questions. I don't think people are trying to be evasive. We just really don't know.

None of the AZ meds helps everyone who takes them. They are generally helpful to at least some people. How do you know whether a med will help your loved one? Try it. You have done that. What the doctor has tried does not seem to be working. It makes sense, then, to discontinue the meds. What was the reason the neurologist gave for continuing on these drugs? For example, that she hadn't been on them long enough to really see if they work?

It is possible that something not developed specifically for dementia might be helpful to relieve some of the symptoms. For example she is crying all day. Might she benefit from an antidepressant or an anti-anxiety med?

Perhaps it is time to seek a second opinion on the best care plan for her.

It is true that the rate of decline varies enormously from one person to another. I don't think there is any scientific explanation for that, either.

There is a tremendous amount of research going on right now. (My husband donated his brain to this research.) It is very frustrating right now not to have the answers to basic questions. Hugs to you, dear caregiver.
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Sorry to disagree, but in our experience anesthesia definitely affects the brain. Both our neurologist and urologist accept that every time my husband has been under anesthesia he hits a new level of dementia. His cancer surgery was the first time we recognized this. He was highly functional before the surgery and severely dysfunctional for about 2 months after the surgery. He slowly recovered some of his mental abilities. Prior to that, he had episodes of severe dementia after colonoscopies, but we never made the connection. His diagnosis, by the way, is Amnestic Dementia, which is very similar to Alz. but follows a slightly different path. We have rejected even minor procedures that would require anesthesia several times with the full agreement of both doctors. There is a trade-off in this approach and minor procedures that do not add major benefit, are not worth the downslide. So far, we have been successful in finding ways around these procedures. Have not had to face a major problem yet, and will make that decision when faced with it.
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There is no cure for Alzheimer's disease and those meds only mask symptoms. My mom started getting symptoms when she was 80 and now she is 87 and is advanced. She never been on medications to control Alzheimer's but she is manageable (overall) without any psychotropic meds. Even if she were on those meds, eventually even those medications do nothing. Doctors will CLAIM it slows down Alzheimer's but they are merely psych meds--this disease is very slow in progression due to her late onset age (the younger it strikes a person, the more aggressive it is). Along with psych meds and/or narcotics are complications such as higher risk for falling. It is highly doubtful anesthesia from eye surgery accelerated her dementia--but of course there are risks when it comes to any kind of surgery and anesthesia--however it is better than going blind in my opinion. Her disease progression most likely would have increased even without surgery.
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Yes, please have her checked for a urinary tract infection. As someone said, it can wreak havoc with the brain of an elderly person and women seem to get them more often.

Also, yes, certain types anesthesia can accelerate cognitive decline. Sometimes the cognitive decline is undiagnosed and in these patients, their cognitive impairment is much more noticeable after surgery. I've seen it resolve within a few months after surgery but not always.
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If mom is having psychiatric symptoms (crying all day? How awful for her!), I would get her to a geriatric psychiatrist to see what can be done to alleviate her symptoms.

Also, have her checked for a UTI; in the elderly, one of those can wreak havoc with thinking processes.
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My mom was 60 when she had knee surgery and started having terrible pychiatric symptoms during the recovery due to meds and anesthesia. So bad the hospital called me. She was diagnosed with Lewy Body a year later (well I diagnosed her and then it was confirmed,lol). I do believe the surgery sped up the disease,but of coarse didn't cause it. I wish she never had the surgery. She's 72 now,and will be entering a nursing home in 2 weeks.
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I say yes and mom's Dr said yes. I asked the same question. We have discovered that mom has small vessel disease which causes vascular dementia. Every time she would be sedated we would lose part of her. It doesn't mater if it's just for a quick colonoscopy. The symptoms of dementia didn't show up until she was having trouble sleeping and they gave her a drug to calm her nerves.....bam....severe dementia. She has since regained some of herself after stopping the med, it took several weeks though. Certain drugs slow or restrict the blood vessels which caused her issue. They use drugs to sedate (relax body/ nerves). This is our experience. I'm sorry you are both going though this.
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Absolutely, anesthesia will speed up ALZ or dementia. My mother had surgery & we were warned by her Surgeon that her ALZ would be much worse. Not might be - would be - and it was.

I was just recently told that you can ask the Anesthesiast to take this into consideration before surgery & they may be able to use other types of anesthesia trying to avoid the severity of the advancement of the dementia. I wish I had known this.
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The sedation used for cataract surgery is extremely mild---the main method of anesthesia is either topical anesthesia or a block that goes directly in the eye socket. It is nearly impossible for either of those to cause dementia or to cause progression of dementia. Prolonged general anesthesia can cause cognitive decline in the elderly, but it doesn't "cause" Alzheimer's or dementia. You also cannot compare cataract surgery to surgeries that other posters are commenting about---knees, shoulders, cancer surgery. Cataract surgery takes literally about 10 to 15 minutes, and the patient is either awake or very lightly sedated, and that sedation is completely worn off by the time they go to the recovery room.
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I am a retired nurse anesthetist and practiced for over 40 years. Any sedative, narcotic, or general anesthetics could cause cognitive impairment but they don't cause Alzheimer's or other dementia so. They may exacerbate symptoms already there. Very little sedation is needed for cataract surgery and the benefit of improved vision is worth it. My dad had a cardiac arrest at home and 45 minutes of CPR at home and at the hospital. He was left with significant cognitive impairment which actually improved for a while, then declined near the end of his life 14 years later. During that 14 years, he had several hospitalizations. What we found affected his mental status were just being in the hospital, general anesthesia, fatigue, etc. all of these were temporary and improved after return to familiar settings. He had cataract surgery twice during that time without problem and the surgery improved his quality of life. Dementia is a cruel disease but isn't caused by anesthetics/ sedatives but it's symptoms can be exacerbated by them. Weigh the risk/ benefits.
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