Can MAC anesthesia for cataract surgery accelerate dementia?

Thank you all for your thoughts. She has been checked for UTI's and has not had one. We are awaiting approval for an MRI to confirm diagnosis of Vascular Dementia/ALZ

Cateract surgery is done with a local. You r not put under. I think, like someone said, it could be a UTI.

Any type of anesthesia can cause problems.
It may take a month or more for it to fully "wear off" and if she had several surgeries within that time frame that could have caused more problems.
Not to mention the confusion and all the "new" people in the hospital asking questions that she may or may not understand.
Also getting or interpreting confusing messages between her eyes and her brain could have caused more of a problem. If she has had poor vision for a long time and all of a sudden able to see more clearly that in and of itself could be hard for her to understand or her brain to interpret.
The best thing to do is keep her as calm as possible and with the same routine. These are comforting things for her.
She will never return to her pre surgery level. That could be due to several factors. the time that is needed to recover from anesthesia she may well have had continuing decline. As well as her mind now having to try to process a more clear field of vision.

Depending on how severe or what "stage" she is in you might want to think carefully if she should require surgery again. Eyes are easy as they require little or no rehab. A broken arm, leg, hip the surgery is difficult enough but rehab is almost impossible as a person with Dementia has a difficult time following directions and participating in rehab.
If a fall results in a broken bone that "needs" surgery it might be time to call in Hospice. But this is a discussion to have LONG before an accident occurs.

I strongly advocate against self-medicating for your mother. Unless you are a medical professional, you should always go along with her doctor's protocol of care. If you think the doctor's care is not your liking, seek a second opinion.

The primary disadvantages of MAC are the lack of airway control and the threat of aspiration or obstruction. To minimize these risks, the anesthesia personnel must titrate the medications carefully to maintain spontaneous respirations while maintaining an anesthetic depth, allowing the patient to remain comfortable. Careful selection and administration of medications is essential in producing the desired and optimal intraoperative anesthetic effect and postoperative outcomes.

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.

I am so sorry that you have to face this with your mom. I hate Alzheimer. I wish God would take people before they go this way. It is so sad. I wonder if in the old days when they did not have the drugs we have now, whether people suffer from Alzheimer as they do today. I listened and watched a friend of mine start to decline, but, Woopie, she is 90 now and is still driving. She is active. Alzheimer is just the worst decease on the planet earth. Good wishes...

I'm so sorry you and your Mom are going through this. My Mom's descent into dementia was also rapid starting with a hospitalization. Or maybe that's just because I started spending 24 hours a day with her then and saw what was really happening. It has been so baffling and we hope a brain autopsy someday will provide some answers. Looking back, there have probably been hints for 20 years. Any time she took Ativan (Lorazepam), the underlying dementia really expressed itself. Prayers for you and your Mom and all those in this today.

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.

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.

My mom underwent surgery for a broken arm. She was diagnosed with ALZ prior to this and was in assisted living. The doctor stated that the anesthesia could make her ALZ worse. It did. She never recovered and passed away 5 weeks later. I don't regret her having the surgery because her arm would have been deformed without it. It's all in God's timing - not ours.

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.

Yes, certain medication, especially those designed to alleviate pain can affect mental function. My mother had a shoulder operation a few years back and was attached to a pump which was to dispense pain medication as she needed it. While recovering from the anesthesia she rolled onto the pump and got a tremendous overdose. It took her 2 days to come out of the anesthesia and when she did she could no longer speak (aphasia) or think clearly and had severe stomach problems which have since subsided but not the mental condition. Of course, as she has aged she has deteriorated even more. She was perfectly fine at age 79 before this surgery but now at 89 cannot remember anything from day to day nor can she speak coherently.

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.

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.

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.

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.

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.

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.