I'm not a Health Care Professional. But this is the exact place my questions need to be answered! My father was just diagnosed with a progressive form of AD. A year ago...he underwent an operation. After this operation he quickly began to lose his Math skills, being an Estimator for a paving company...he lost his job. His job of 50 years was his life! He went downhill fast, emotionally. 6 months later he was getting lost in the house. Frantically, I tried to get my mom to get him tested so we could see what was wrong. She begged me to wait until after he underwent YET ANOTHER oral surgery to have 4 titanium implants into his lower jaw. He again, in less than a year...went under anesthesia. His condition worsened at an alarming rate! He started having delusions, confusion, conversations that one word didn't go with the next! I KNOW FOR A FACT that anesthesia does exasterbate AD if it's there...but it also ACCELERATES it!!! WHY ARE WE NOT BEING TOLD??? The Dr. mentioned that 85% of his patients are there because of anesthesia! My dad may have had AD before...but it would have progressed more slowly! Families need to be warned and studies need to be done. My dad is only 67, and I've had to face the fact that I've LOST HIM as he was! I am LIVID, and I want answers! Let's band together if you've had a similar experience and demand answers for our loved ones!!! It may be too late for ours but we may be able to help awareness save a lot of others from such terrible heartache!

Dear Sherrie,

I can understand how you must be feeling! It is very painful to see your loved one taken by this terrible disease! Regarding your question about the effects of anesthesia, it has been suspected that some elderly patients develop dementia following anesthesia and surgery. Yet, little is known about the effects of anesthetics on the aged brain, and more research needs to be conducted. There is a chance that the disease will accelerate when a person diagnosed with Alzheimer’s disease goes through surgery. Patients with Alzheimer’s can experience increased confusion for quite some time after receiving anesthesia, and family members would want to be prepared to offer extra supervision and reassurance. It is important for families to know that there may be a prolonged recovery time post surgery. For someone in the early stages of the disease who is able to perform daily activities, the general level of the person’s mental status will decline temporarily post surgery and anesthesia. Mental decline for a person in an advanced stage may not be temporary. In other words, the patient may not return to their prior level of functioning before the surgery. Unfortunately, some doctors don’t discuss the possible side effects of anesthesia with the family or caregiver. Therefore, it is recommended that the family speak to the individual’s doctor, surgeon, and anesthesiologist prior to surgery. Also, the anesthesiologist should be informed ahead of time if a person with AD is taking one of the memory medications, as this may influence the choice of anesthesia.

You are a caring person and I understand how awful this is to you. I suggest that you and your mom attend a support group and educational programs to help you understand the disease. Your Local Chapter of the Alzheimer's Association can tell you about community resources in your area. If you need to speak to someone, please call our helpline at 1-800-272-3900 or write to us again on this forum.

Griselda,

Thank you SO much for replying. What can I do to try to bring this to the forefront of the Medical World? News Media? An investigation should already be in the works. I've been bombarded with e-mails from others in the same sad dilhemma. It's too late for us...but we can still help others by stirring up awareness. But how?

=0(

Please can someone help???

The terrifying thought that I've had since this all happened to my dad in less than a year is... that perhaps anethesia, or putting your brain to sleep, for a period of time...actually causes brain-damage?

What IF...the Medical world is covering this up with the Alzheimer's diagnosis? It would be eassier to say that your LO had a pre-existing condition than to risk a lawsuit!!!

Now, I myself am terrified to ever have anesthesia..and am incredibly afraid for anyone in my family if they need an operation!

I've been through the depressed/crying stage, and NOW I'm VERY, VERY ANGRY. Something very precious was taken from me...and SO many others.

Still looking for help out there from someone that has a voice and WILL be heard!!! Help!

Hello Sherrie,

Your anger is understandable given that a person you love very much is, in many ways, disappearing from you. You're losing your relationship with your father as you have known it and you're watching him decline quickly. On top of that, you did not have information about the possible effects of anesthesia before your father had these procedures done and if you had known some things, your family may have been able to make different decisions. You have many unanswered questions about your father's experiences and I would suggest that you have him seen by a specialist. Here is a link for the national site for Alzheimer's Disease Centers National ADC Site.

Also, given the extreme emotional stress you are experiencing, please remember to take care of yourself each day. Spend time alone or time with others who will listen to and support you. Try to enjoy small pleasures like taking a bubble bath, walking at sunset, watching a movie, or eating a favorite food. Set small goals for each day and each week to help yourself get things done and also to give yourself something to look forward to, Also, seek professional counseling and support.

It can be helpful and therapeutic to take action towards a cause that has affected you and affects many others. I agree that it is important for families to know the potential effects of anesthesia. For now, I would encourage you to get more information about your father's experience in particular. Speak directly with the people who have treated your father and get as many answers from them as you can. also, please cal the 24 hour helpline if you would like to speak with a counselor about what you're going through at 1-800-272-3900

As many others have said, I feel your pain & anger!!!!!!!!! I'm experiencing a very similar situation right this very moment. My dad has always been a person with not much to say but his kindness & loving hugs would say it all. My father was diagnosed with early stage Alzheimer's last year. He also has diabetes, parkinsons, high cholesterol, clots & high blood pressure. Granted he's not a healthy person but then again he's 80 y.o. About 10 days ago, my father slipped & fell in the kitchen & fractured his hip. Needless to say, the orthopedic physician advised either he have surgery or be bedridden for the rest of his life. The morning of the surgery, I asked to speak with the anesthesiologist. When I spoke with him, the first thing out of my mouth was "my father has alzheimer's" in addition to his other medical conditions. He also had it in the chart that he suffered from alzheimers. In my conversation with the anesthesiologist, I had asked him if there was anything else besides grogginess that I can expect. HIS ANSWER WAS "NO" !!!!!! I took his answer & consented my father to have general anesthesia. The next day my father was halucinating & trying to rip out his IV's. It was scary since my father has never been a violent or anxious person. His behavior scared me, my mom & my 8 year old son. I found out day 2 post-op that sometimes anesthesia aggravates Alzheimers symptoms & it can take up to 2 weeks before he returns to his normal self/ the anesthesia wears off. I was never advised by any of the doctors nor the nurses prior to surgery. If I would have known, I would have requested a local anesthetic be used instead. Now its day 11 post-op & my father has not improved at all. He is now in a very advanced stage of Alzheimer's. He halucinates & actually got violent with me & hit me in the arm. He's currently in a rehab/nursing home & because of his condition, he has to have a "baby sitter" throughout the night so he doesn't hurt himself. So you can see, I too am EXTREMELY ANGRY!!!!!!!!!!!!!!!!! My family has considered filing a malpractice lawsuit against the anesthesiologist for neglect of properly informing me of all the risks & "after-effects". I am a fair person & am waiting for a couple more days before I actually sign the paperwork with my attorney. I feel robbed & lied to. He stole what was left of a quality type life from my father & memorable moments with my son. I know that I can not get my father back to his pre-alzheimer years but how could you rob someone's family & life - this is a question I've been asking myself for almost 2 wks. If you do go public, please let me know as I also would like to share my story.

My prayers are with you & your loved ones !!!

Thank you for sharing your anger and experiences. Please keep up the fight. I am concerned about my own mother as she approaches another knee surgery but does not have a diagnosis.

My grandma was in the early stages when she fell and hurt her arm, she had to have surgery and was given anesthesia and from then on she progressed down hill very fastly. I am very sorry for your loss.

I wanted to reply to this discussion. I was told I had EOAD April 2008, I was 57 years old. I had surgery for a compressed spinal cord in Jan. 2008. Prior to that I had a job, I would get lost coming home from work, I had been an insurance adjuster for 16 years, had good math skills. Now, simple math is hard for me, my spelling is terrible, my handwriting has changed. Short term memory is bad. To make a long story short, I ask my neurologist at my last appt. in March, if this could have caused this to come on sooner by having the surgery. He stated that only if there was oxygen not getting to the brain. I have read so much about this, at times I don't know what to believe. I agree if there is any chance this is happening we need to be told.

Sharon

I am an anesthesiologist who has a very dear loved one with AD. I am very knowledgeable about the topic of anesthesia and AD. The anger and sadness of all those who posted is understandable, but some of it is probably misdirected. First, there is certainly no effort to keep secret what is known about anesthesia and AD. on the contrary, it is the subject of many ongoing research studies to try to give medical professionals and family members better insight into the risks of anesthesia for patients with AD. There are new articles published every month which provide additional information.

Next, many persons with AD simply require anesthesia for surgical procedures in order to survive or tolerate life. The elderly person with a hip fracture is an example. It is generally considered inhumane not to operate: a fractured hip causes enormous pain and immobility. Together, they usually result in rapid but unpleasant death in the elderly who do not benefit from surgical repair to immobilize the movement of bone fragments grating against one another.

Next, persons with AD deteriorate at unpredictable rates. Although many in fact do deteriorate after anesthesia, many also deteriorate after a trip to a ball game or a visit to Aunt Bertha's. The fact that they deteriorated does not show that one caused the other. Any change in routine and surroundings can trigger deterioration in someone with AD. And, it is also the case that many, many persons with AD and related dementias go through anesthesia for major surgery and bounce back beautifully.

The evidence regarding relative risks of general anesthesia compared to alternatives such as spinals, epidurals, and other types of "local" anesthesia is surprising: studies generally have shown that as many people have problems after local anesthesia (called "regional anesthesia" by anesthesiologists and anesthetists because these techniques anesthetize or numb only one part or region of the body)as after general anesthesia.

Further, some surgical procedures simply cannot be accomplished without general anesthesia.

What everyone should agree with is that communication between doctors and patients' families is crucial. Family members need to explain to doctors how serious the AD is. Is it mild or is the patient confused all the time? Has she deteriorated previously with changes in routine? A ten minute consultation about a surgical problem done by a physician who has never met your loved one previously will not result in recognition of all the changes in your loved one's behavior and functioning that you are aware of.

Family members will get the best exchange of information by asking specifically "What alternatives exist to this surgical procedure?" Unfortunately, in the real world, the answer to that question often is "There are no alternatives". That's when the very hard work of family members---making the best decisions possible for loved ones---begins in earnest!

Dr. Thomas,

I was told by an anesthesiologist that he believes there is a link between decline in AD and anesthesia. Of course, not everyone declines, Thank God! Also, we don't know for sure if it's the anesthesia or the fact that the patient is going through a tramatic procedure. I don't think anyone will argue that if it is the only way to go, of course our Loved Ones need to have surgery. But, if there is an anesthesia that is known to be "better" for AD patients, I think we should all be told about it and have access to it.

The doctor told me that there is an anesthesia that he has used where he noticed significant improvement in recovery and alertness in dementia patients. The problem is that they didn't use this method at this hospital, and now I am scrambling to find out what it is called and what hospital uses this anesthesia. He had told me that it wasn't just a medication, but a whole different set-up and equipment.

If you're out there and you know what this might be, please let me know. They have scheduled my Mom for surgery tomorrow to remove kidney stones and put a stent in the ureter. I have not signed the consent forms for the surgery because I want to find out about this other anesthesia and transfer her to another hospital for the surgery if they don't use it here.

Thanks, Felicia

Hey. I'm so sorry to hear that there other people in my situation, but on the same hand, I'm glad to finally know that we're not crazy. We knew that it was all to coincidental...His surgery then the Alzheimer's. My dad NO PREVIOUS SIGNS OF ALZHEIMER'S, as a matter of fact; my dad was the most hardworking, loyal, honest, loving, generous hilarious father and husband, a man could possibly be. My dad (a 20 yr. veteran of the United States Airforce) was 71 years old in 2004 and up until his retirement, from the work force, in 1995, as District Manager of Marriot Contract Div., he only missed 1 day of work in his entire life, due to a 104 degree temperature. He worked in the yard until late in the evenings, did all the grocery shopping for him and my mother, helped clean their house, pay their bills, was the best cook you could even imagine, among a multitude of other things, but the most important thing, that wonderful Christian man did daily... was take care of my mother that is a severe diabetic and has had quadruple bipass surgery. But on one tragic day, in April 2004, staying busy, as he always did...My dad was outside taking the seats out of their van, to clean. He ended up falling over the seat, onto his back, on the the concrete driveway. At that time, he ruptured several disks and cracked his vertebrae. His only option...to have back surgery. Then immediately following his surgery "boom"...almost like he had just had Alzheimer's inserted in to his brain during surgery or something. From that point, it was on, full blast. His memory quickly deteriorated and 5 years later, he lays in a hospital bed in my mother's home, in diapers and plastic sheets, never to even walk again. He lost total motivation for everything, but t.v. He stopped getting up and around and eventually lost all his muscle mass and mobility. My 74 yr old, unhealthy mother is only caregiver, as she pops her nitros and forgets to take her insuline and on some days, takes my dads medicine by mistake. Being a retired USAF veteran, my dad should have had a place in the Tuscaloosa VA, but apparently there is no room in their facility, for him. So, the Tuscaloosa VA sent a physical therapist and a nurse out, to check vitals and take blood for a few weeks, but then issued several invoices, totally over $1000 to my 74 yr. old mother, living off SS and my dad's AF retirement. I go 3 times a week to their house, to help my mother change his sheets and I clean their house while I give my mother a break so she can attend church, but there's only so much I can do, with a full time job and a family of my own. The only thing that keeps my mother going is the wonderful, constantly joking father that tells her daily how much he loves her, how beautiful he thinks she is, how much he appreciates her and how he's so glad she's his wife, but quickly preceding "How many children do we have?"; "Is Danette our daughter?"; "Does Erby know he's Danette's son?"; "Are my parent's dead?" to talking to his parents that have been dead for over 20 yrs and believing they are in his room visiting him, and so on. How does this happen to a man that did not have one single other thing wrong with him until his surgery and then wakes up with this horribly devistating disease? This is NOT fair to dad, my selfless mother, or even to me. Not only has this disease taken my father from me, but will also be death of my mother. Where is the help? Where are the reprecussions for this anesthesia?

Dear Danette,

Thank you for writing us your experiences Danette. Your father’s life sounds pretty amazing, and I am so very sorry to hear what has happened to his health and how it is affecting your family. After your dad’s surgery and your family started to notice changes a lot began to change all around you. Your dad’s abilities, perhaps his personality, your mom’s health, and all the other changes you have seen in the past couple years can feel pretty overwhelming. It sounds like, at this point your dad is going through more changes in his memory as he struggles to keep the details of his life straight, and it is great that your mother is still able to be by his side. However, as you may be aware, there comes times throughout this disease that it is important to begin evaluating the level of care our loved one’s needs. You may be seeing your mom needs more breaks as your dad’s needs increase as well as your own need to take some time for yourself and your family. At these crossroads families may sit down and really look at the future of care, as well as current care options for their loved one. I encourage you to call our helpline a begin talking with one of our care consultants about these options and how to take any next steps. Call us anytime at 800.272.3900

In regards to your family's very important experience with Anesthesia. Although here is research and an understanding of Anesthesia affecting a person with the symptoms of Alzheimer’s disease by increasing the symptoms in some cases, I am not fully aware of the direct link from the risk of anesthesia with a cognitively well person to begin showing signs of Alzheimer’s disease. There is some discussions about older adults who receive anesthesia become delirious or experience what is often termed a clouded delirium or dementia. This type of dementia more commonly known as delirium, if caught early enough may be reversible. Often times older adults may experience delirium for a short period after surgery many see a return to normal fucntion later. If anyone should think their loved one is experiencing this reaction to a surgery or strong medication, it is important to contact their physician to evaluate the cause and possible treatment of this reaction.

I really want to express how important it is that you Danette and others become the voice and advocates for your loved ones who are going through this disease. Please call our helpline to discuss more care options, or other issue you and your family are affected by.

Bests,

ttt for TonyNZ

Iris L.

Thanks Iris L.
Iris bumped this up for me to find after I questioned the link between Anesthesia and AD in the chat room. My wife had surgery in 2004 aged 54yrs and was diagnosed with AD in 2006 aged 56yrs. As yet I haven't found out whether she was given Isoflurane, but as has been said above, there appears to be some concern from some family members and caregivers about the link. My mind is still open on the matter.

This is all informative and scary to me. My mom has colon cancer and has been advised of course, to have surgery to remove the tumor and a portion of her colon. She is 85 years old and has moderate Alzheimers, she was diagnosed about 4 years ago. My siblings and I are concerned that the trauma of the surgery will send her quickly into advanced stages of Alzheimers, but how do we "not" treat the cancer? It is huge thing to consider..any ideas?

Dear J Bracey,

What an extraordinarly difficult situation for you and your family. Not only are you coping with your mom’s Alzheimer’s disease, but another very serious medical condition, cancer. This is a scare place to be, but there some things to consider and think about.

Surgery and many serious medical procedures, medications, infections, etc. can affect a person with Alzheimer’s disease. Sometimes these affects are temporary and improves as the persons recovers from the other medical condition. I encourage you and your family to have this conversation about the affects of the surgery with the doctors involved in not only her cancer care, but also her Alzheimer’s disease care. It will be especially important to talk with the anesthesiologist about these risks. At this point it may help to gather all the facts you can from these professionals after you lay all your concerns out on the table. They may offer other options, or suggestions. Be as open as possible with them.

This is a very huge consideration you and your family will be making. One guidance point that often helps families in these situations is to think about which option or choice leads to the best quality of life. This point focuses family not on quantity of life but quality, one way of looking at this. Learning the facts about what would happen if the cancer was not treated in this way is important to understand this point. How would her quality of life without the surgery be comparable to the possibility her Alzheimer’s disease progresses rapidly? Whether or not the surgery will greatly affect her is going to be hard to know. It may be likely, but not guaranteed.

I strongly encourage you to call our helpline 800.272.3900 and talk this through more with one of our dementia care counselors. They may be able to provide you with more guidance as you walk down this difficult path with your family. Please start by talking with your mom’s doctors about the risks and benefits of the surgery. And please use this online community as a supportive place as well. Many persons affect in different ways by Alzheimer’s disease come here to share tips and find support. I would like to welcome you to this community.

Please take care, and let us know how can help you. Call 800.272.3900 to reach our helpline.

Bests,

Hello. Oh my gosh, I just found this thread - after it's too late I'm afraid. I could have written Scuba's post word for word! My dad is only 63 (just turned 63). He was just diagnosed with early Alzheimer's in the last 3 years. On Oct 1 (a week before his 63rd birthday), he had to have a kidney stone crushed. They used anesthesia. He hasn't been the same since! He's in the hospital now.
I'm gowing crazy!!!! All of his tests have come back negative (as far as infections, heart problems, diabetes, etc). He's hallucinating, talking gibberish, can't remember his birthday.
It's like his AD went off a cliff and progressed 30 years in a week!

HOW CAN THIS HAPPEN????????? We live in Indiana.

Scuba - if you're still reading here, I would love to 'talk' with you and see how your dad is doing, etc. Also, anyone who could please post, I'd be soo soo grateful. I'm so angry and upset. I drove home from the hospital last nigh sobbing and screaming in my car. I felt like so many years with my dad were just ROBBED from me in an instant. And not one doctor mentioned a THING about anesthesia excasberating (sp?) Alzheimer's/dementia!!

Thank you in advance to anyone who can share or talk!
Lost Amy in Indiana

KathyR - I'm sorrry, I forgot to mention you too!! I would love to talk to you too.
I'm afraid my dad won't be able to come home from the hospital. They have to restrain him at night because he's so restless and keeps trying to pull out his IV!

I have tears rolling down my face as I write this!

And I'm wondering if his hernia surgery a few years ago is what set this whole thing in motion in the first place!
It's been 3 weeks since the latest anesthesia and at first he was just 'down' and in pain from the kidney stones. But he's mentally just going downhill fast. I feel so robbed. It's not right!!

Wow, everything I have just read brings such awful memories back to me. Elsewhere on the site, I did post a brief background on my hubby but here goes again: At 79 yrs. old, he had to have heart surgery. A week before the surgery he had a retirement party at the school where he had been a high school math/science/biology teacher. The drs. insisted if he did not have his aortic valve replaced his heart would eventually explode. Sooooo, we agreed.

The day of surgery, all was fine, he was in CIC and doing well when all of a sudden he started to go -- all the alarms went off, a Code Blue was called and I was a looney for all that time. It was discovered he was bleeding internally and had to go back into surgery to find out why and where. He made it through that surgery (not even 6 hrs. after the first mind you) after being cracked open and put on the heart lung machine TWICE in one day and being blasted with all the anesthesia. Well, he woke up out of that a changed person.

While still in the hospital, the hallucinations were constant, the behavior was 180 degrees from what he used to be, etc. I was scared to death. When we finally got him home, it was no longer the man I knew. And it has gone downhill since then. He is now 84 and completed incontinent, babbles instead of talks, gets belligerent and argumentative, and mostly just sits and stares at nothing or watches t.v. and eats. It has been an extremely rapid decline and almost five years ago he was diagnosed with AD. He did have a few small strokes (showed up on a PetScan) as a result of the two surgeries which sure didn't help.

So now I sit here and wonder over and over and over if the heart surgery should have been done or not -- but we can't undo what has already been done. And I know the strokes take their toll, but I too believe the anesthetic didn't help either at his age.

He did have to have his wisdom teeth cut out a year ago and I begged the surgeon to not put him under but they said they were going to give him "just a little" or he would not be able to stand the pain -- well, it took him over a week to actually rebound from that and I have sworn he will never, ever, ever be put under ever again!!!

I hate what you are going through and your anger cause I feel it every day and I carry such guilt (I know it is not my fault but keep thinking I should have been smarter and said no to so many things) and now our lives as we once knew them are gone. And I no longer have my dear sweet husband -- he is a different person and I miss him so much. Five years and counting. I try to keep my sense of humor for my sanity's sake, but the deep seated anger is still there and I always NOW have the last word with the drs. They are not going to do one more thing to him that could worsen this already bad situation. God bless you and know you are not alone. Love, Barb

Alzheimer's disease (AD) is associated with a loss of cholinergic neurons resulting in profound memory disturbances and irreversible impairment of cognitive function. The central cholinergic system is involved in the action of general anaesthetic agents. Anaesthetic modulation of cholinergic transmission has profound effects on brain function via a cascade of synaptic and postsynaptic events by binding both nicotinic and muscarinic receptors. During general anaesthesia, decrease in acetylcholine release and depression of cholinergic transmission facilitates the desirable effects of general anaesthetics, such as loss of consciousness, pain, voluntary movements and memory. From this point of view, patients with AD, characterized by a compromised neuronal transmission, represent particular cases in which the choice of anaesthesia drugs may have a negative effect on the postoperative outcome. A future challenge may be the identification of brain targets of general anaesthetics which do not expose patients to postoperative cognitive dysfunction, nor interfere with prognosis of brain degenerative disease.

Central nervous system complications remain a common problem after surgical procedures in patients with AD. Despite major advances in surgical techniques and anaesthetic management, a patient might not be able to return to their baseline status and could require more intensive care by the family or in a long-term care facility because of deterioration in cognitive function. This, in turn, can be an enormous cost to society in terms of suffering and consumption of resources.43 Despite doubts about the involvement of anaesthesia in the development of AD, it is clear that drugs given during anaesthesia interfere with cholinergic function in the brain by several mechanisms. In addition, neurotoxic effects have been demonstrated for several anaesthetic agents.

Inhaled anaesthetics enhance peptide oligomerization and cytotoxicity of AD-associated peptides. The majority of surgical patients receive inhaled anaesthetics. These results call for further evaluation of the interaction between neurodegenerative disorders, dementia and inhalation anaesthesia.

Propofol inhibits oligomerization at low concentrations but enhances only at very high concentrations. In addition, propofol does not enhance beta-A toxicity. These and other results indicate that both propofol and thiopental are considered to be relatively safe with respect to APP metabolism. One of the difficulties in human research in this area is the fact that anaesthesia is not administered as a sole procedure but is almost invariably given to facilitate surgery and, as reported above, often in emergency conditions. Surgical stress, in turn, may accelerate development of clinical signs and symptoms of AD.

All these aspects make it very difficult to draw any conclusions, without risk of bias, about the anaesthetic agents to be used or avoided in patients with AD.

New clinical and experimental evidence is required to help anaesthetists make the best choice of anaesthetics for the patient with AD. We believe that investigation of the effects of drugs administered during anaesthesia on the central cholinergic system may open new scenarios on the possible interactions between AD and anaesthesia.



originally published online on September 1, 2006
British Journal of Anaesthesia 2006 97(4):445-452; doi:10.1093/bja/ael233

quote:

Originally posted by scubadiva:
I'm not a Health Care Professional. But this is the exact place my questions need to be answered! My father was just diagnosed with a progressive form of AD. A year ago...he underwent an operation. After this operation he quickly began to lose his Math skills, being an Estimator for a paving company...he lost his job. His job of 50 years was his life! He went downhill fast, emotionally. 6 months later he was getting lost in the house. Frantically, I tried to get my mom to get him tested so we could see what was wrong. She begged me to wait until after he underwent YET ANOTHER oral surgery to have 4 titanium implants into his lower jaw. He again, in less than a year...went under anesthesia. His condition worsened at an alarming rate! He started having delusions, confusion, conversations that one word didn't go with the next! I KNOW FOR A FACT that anesthesia does exasterbate AD if it's there...but it also ACCELERATES it!!! WHY ARE WE NOT BEING TOLD??? The Dr. mentioned that 85% of his patients are there because of anesthesia! My dad may have had AD before...but it would have progressed more slowly! Families need to be warned and studies need to be done. My dad is only 67, and I've had to face the fact that I've LOST HIM as he was! I am LIVID, and I want answers! Let's band together if you've had a similar experience and demand answers for our loved ones!!! It may be too late for ours but we may be able to help awareness save a lot of others from such terrible heartache!

Considering that over 200 million people undergo surgery each year, it's important to know whether common anesthetics could increase one's risk for Alzheimer's or other cognitive disorders.
Researchers at Massachusetts General Hospital/Harvard Medical School recently studied human brain cells subjected to the common anesthetic desflurane for six hours in order to simulate a surgery situation. They found that when oxygen levels were normal, desflurane did not adversely affect the brain cells. However, when the cells were subjected to low oxygen levels, the desflurane was associated with increased production of beta amyloid, a protein found in elevated quantities in the brains of those with Alzheimer's. Low oxygen alone did not increase beta amyloid production.

What does this mean? The researchers say that because the study used cell cultures, their next step is to test the findings in animal models. It's not certain that anesthesia and low oxygen actually increase beta amyloid production in humans during surgery, but this is an important area of study given the prevalence of anesthetic use in medical care.

quote:

Originally posted by Crazy Blonde:
Wow, everything I have just read brings such awful memories back to me. Elsewhere on the site, I did post a brief background on my hubby but here goes again: At 79 yrs. old, he had to have heart surgery. A week before the surgery he had a retirement party at the school where he had been a high school math/science/biology teacher. The drs. insisted if he did not have his aortic valve replaced his heart would eventually explode. Sooooo, we agreed.

The day of surgery, all was fine, he was in CIC and doing well when all of a sudden he started to go -- all the alarms went off, a Code Blue was called and I was a looney for all that time. It was discovered he was bleeding internally and had to go back into surgery to find out why and where. He made it through that surgery (not even 6 hrs. after the first mind you) after being cracked open and put on the heart lung machine TWICE in one day and being blasted with all the anesthesia. Well, he woke up out of that a changed person.

While still in the hospital, the hallucinations were constant, the behavior was 180 degrees from what he used to be, etc. I was scared to death. When we finally got him home, it was no longer the man I knew. And it has gone downhill since then. He is now 84 and completed incontinent, babbles instead of talks, gets belligerent and argumentative, and mostly just sits and stares at nothing or watches t.v. and eats. It has been an extremely rapid decline and almost five years ago he was diagnosed with AD. He did have a few small strokes (showed up on a PetScan) as a result of the two surgeries which sure didn't help.

So now I sit here and wonder over and over and over if the heart surgery should have been done or not -- but we can't undo what has already been done. And I know the strokes take their toll, but I too believe the anesthetic didn't help either at his age.

He did have to have his wisdom teeth cut out a year ago and I begged the surgeon to not put him under but they said they were going to give him "just a little" or he would not be able to stand the pain -- well, it took him over a week to actually rebound from that and I have sworn he will never, ever, ever be put under ever again!!!

I hate what you are going through and your anger cause I feel it every day and I carry such guilt (I know it is not my fault but keep thinking I should have been smarter and said no to so many things) and now our lives as we once knew them are gone. And I no longer have my dear sweet husband -- he is a different person and I miss him so much. Five years and counting. I try to keep my sense of humor for my sanity's sake, but the deep seated anger is still there and I always NOW have the last word with the drs. They are not going to do one more thing to him that could worsen this already bad situation. God bless you and know you are not alone. Love, Barb

Check this Journal article for more information:


Alzheimer's and Dementia, Volume 5, Issue 4, Supplement 1, July 2009, Page P389
Brenda L. Plassman, Kenneth M. Langa, Emily V.A. Finlayson and Mary A.M. Rogers

quote:

Originally posted by AmyAlex:
KathyR - I'm sorrry, I forgot to mention you too!! I would love to talk to you too.
I'm afraid my dad won't be able to come home from the hospital. They have to restrain him at night because he's so restless and keeps trying to pull out his IV!

I have tears rolling down my face as I write this!

And I'm wondering if his hernia surgery a few years ago is what set this whole thing in motion in the first place!
It's been 3 weeks since the latest anesthesia and at first he was just 'down' and in pain from the kidney stones. But he's mentally just going downhill fast. I feel so robbed. It's not right!!

SURGERY USING GENERAL ANESTHESIA AND
RISK OF DEMENTIA IN THE AGING,
DEMOGRAPHICS AND MEMORY STUDY
Brenda L. Plassman1, Kenneth M. Langa2, Emily V. A. Finlayson2,
Mary A. M. Rogers2, 1Duke University Medical Center, Durham, NC, USA;
2University of Michigan, Ann Arbor, MI, USA. Contact e-mail: brenda.
plassman@duke.edu
Background: Short-term postoperative cognitive dysfunction is common
among the elderly. However, to date there has been minimal evidence to support
continued postoperative cognitive decline beyond 6 months. We examined
the association between surgery conducted under general anesthesia and
risk of dementia in a nationally representative sample in the United States.
Methods: We used data from the Aging Demographics and Memory Study
(ADAMS), a population-based study of dementia that used a single standardized
diagnostic protocol and included subjects from all regions of the country.
The ADAMS sample of 856 individuals aged 70 years or older was drawn
from participants in the ongoing Health and Retirement Study (HRS). All participants
received an extensive in-home clinical and neuropsychological assessment
to determine a diagnosis of normal cognition; cognitive
impairment, not demented; or dementia. We obtained the full set of Medicare
administrative records from 1991-2005 to determine details of each participant’s
surgical history prior to the outcome date, defined as the estimated
age of onset for the demented and the ADAMS assessment date for non-demented
individuals. We used proportional hazards models to examine the association
between exposure to general anesthesia and the risk of dementia vs.
normal cognition. Results: We found that surgery with general anesthesia
was associated with increased risk of dementia (Hazard Ratio (HR) ¼ 2.90;
95% CI ¼ 1.70-4.93), independent of the number of hospitalizations prior
to the outcome date. This association was evident for non-cardiovascular surgeries
(HR¼3.01; 95% CI¼1.55-5.82) but less so for cardiovascular surgeries
(HR¼2.17; 95% CI¼0.94-5.04). When persons with less than 2 years of
Medicare claims and those with questionable cognition at baseline were excluded,
the association between general anesthesia and dementia remained
(HR¼2.69; 95% CI¼1.51-4.80). Persons with dementia had 27 hospitalizations
per 100 person-years compared to 15 hospitalizations/100 person-years
in those with normal cognition (p<0.001) in the years prior to the outcome
date. Conclusions: Our findings suggest an increased risk of dementia after
surgery with general anesthesia among older adults. If confirmed, this increased
risk for dementia may be an important factor to consider when making
decisions about surgery, especially those that are elective, in later life.
P3-154 PROSPECTIVE STUDY OF DIABETES AND
COGNITIVE DECLINE AND DEMENTIA SUBTYPES
IN CACHE COUNTY, UTAH, USA
Ronald G. Munger1, Jack Charoonruk2, JoAnn Tschanz1, Peter Zandi3,
Christopher Corcoran1, Heidi Wengreen1, Kate Hayden4, Maria Norton1,
Kathleen Welsh-Bohmer4, 1Utah State University, Logan, UT, USA;
2Mahidol University, Bangkok, Thailand; 3The Johns Hopkins University,
Baltimore, MD, USA; 4Duke University, Durham, NC, USA.
Contact e-mail: ron.munger@usu.edu
Background: Type 2 diabetes mellitus (DM) is a well-known cause of vascular
disease and cognitive impairment, but its relationship with specific subtypes
of dementia, including Alzheimer’s disease, is unclear. Methods: The
Cache County Memory Study (CCMS) is a prospective study of 5092 men
and women aged 65þ years at baseline in 1995. Cognitive function was assessed
with the Modified Mini-Mental State Examination (3MS) at baseline
and 3, 7, and 11 years later. Dementia was assessed by clinical examination
and standard diagnostic criteria. Diabetes history was self-reported and persons
with dementia at baseline were excluded from the analyses. Multivariable
mixed effects models were used to evaluate differences in 3MS scores
and Cox proportional hazards models were used to evaluate risk of all-cause
mild cognitive impairment (MCI), all-cause dementia, and dementia subtypes.
Results: DM was associated with a lower mean 3MS score at baseline
(-0.92 points, p<0.01) that was maintained over all examination waves.DM
was associated with risk of all-cause MCI (hazard ratio (HR) ¼ 1.57; 95%
confidence interval (CI) ¼ 1.24, 1.98) and all-cause dementia (HR ¼ 1.49,
CI ¼ 1.13, 1.97). A stronger association was found between DM and the dementia
subgroup consisting of AD þ vascular diseases and vascular dementia
(HR ¼ 2.93, CI ¼ 1.94, 4.43). These results did not differ by sex. No
significant overall association was found between DM and risk of AD in
the absence of vascular disease (HR ¼ 1.26, CI ¼ 0.89, 1.78) however a difference
was found by sex with a positive association for men (HR ¼ 2.25; CI
¼ 1.24, 4.08) and no association for women (HR ¼ 1.10, CI ¼ 0.63, 1.93).
ConclusionsMwas associated with lower 3MS scores, MCI, all-cause dementia,
and dementia with vascular disease in the Cache County Memory
Study. AD in the absence of vascular disease was associated with DM in
men but not women. DM appears to primarily contribute to age-related cognitive
disorders via vascular mechanisms. In the absence of vascular disease,
DMmay have more subtle neurodegenerative effects via non-vascular mechanisms
that vary by sex

quote:

Originally posted by scubadiva:
I'm not a Health Care Professional. But this is the exact place my questions need to be answered! My father was just diagnosed with a progressive form of AD. A year ago...he underwent an operation. After this operation he quickly began to lose his Math skills, being an Estimator for a paving company...he lost his job. His job of 50 years was his life! He went downhill fast, emotionally. 6 months later he was getting lost in the house. Frantically, I tried to get my mom to get him tested so we could see what was wrong. She begged me to wait until after he underwent YET ANOTHER oral surgery to have 4 titanium implants into his lower jaw. He again, in less than a year...went under anesthesia. His condition worsened at an alarming rate! He started having delusions, confusion, conversations that one word didn't go with the next! I KNOW FOR A FACT that anesthesia does exasterbate AD if it's there...but it also ACCELERATES it!!! WHY ARE WE NOT BEING TOLD??? The Dr. mentioned that 85% of his patients are there because of anesthesia! My dad may have had AD before...but it would have progressed more slowly! Families need to be warned and studies need to be done. My dad is only 67, and I've had to face the fact that I've LOST HIM as he was! I am LIVID, and I want answers! Let's band together if you've had a similar experience and demand answers for our loved ones!!! It may be too late for ours but we may be able to help awareness save a lot of others from such terrible heartache!

Hello everyone, I came online to do a search on anesthesia and alzheimer's...I never dreamed so many others are having the same questions as I do now. My Father who is 80 was diagnosed with early stage alzheimers/vascular dementia a year ago after having mini strokes...it was thought he would never go home but he had an amazing turn around....he was never quite the same but was able to cope living alone - he had his drivers license taken but other than that he was high functioning.

On Oct 1 he had surgery for an abdominal anyeurism which was 7.5 cm in size - it was ready to rupture so there was no question it had to be done. The surgeon only mentioned that the anesthesia could affect the alzheimers in passing - he never said this happens often, he never said anything to make me realize how possible this really was. Like I said it had to be done but I am in shock how fast my father is declining.

I keep getting told there is a chance it could turn around as before and he may go home, but when I hear other posters here saying their parent had no prior history and now their parent has full blown alzheimers, it doesn't give me alot of hope.

I was thinking of all the Geriatric Dr's appt's I have gone with my father to and never once did the Dr say that in the future you should be aware should he ever need surgery, this is what could happen...I would think it would be automatic for someone who specializes in this to inform their patients of possible outcomes...lets face it, this is a disease usually in the elderly and it is quite likely that the body will at some point need to have some type of surgery...I am a breast cancer survivor and since I was diagnosed and recovered my oncologist has given me alot of info on what to look for, side effects of treatments etc BEFORE it happens...I just think if you have alzheimers, your family should be told the types of things that can trigger it up a notch such as anesthesia if and when it is needed.

My father seemed to be doing ok after surgery as far as the dementia is concerned, he did end up with gangrene in the leg as well as paralysis of his foot due to lack of blood flow from vascular disease in the legs (hardening of the arteries)...infection,stress,being in hospital could all be contributing to his decline at this point and it really is wait and see...it's just so frustrating.

He was supposed to be in hosp for 1 wk and it has now been a month, I do not know what to expect, whether to start making other arrangements for care etc....At this point he can't even walk and can't even get through a half hr of therapy without being too tired and or aggressive with the therapists...how do you get someone with this disease to co-operate so they can start to walk again? He has a psw 24 hrs a day in his room as he wakes and forgets he cannot walk and is a fall risk.

I just wish I knew what to expect - last year when he was diagnosed I was told to put him in a home, he could never live alone, he spent 2 mnths in hosp and just before the second month he made a turn around and they told me well yeah I guess it's a good thing you didn't get rid of his apt or he would be having to go home with you...this is while I was going through chemo...I don't think so. I just don't know what to do and I guess all I can do is wait...

Has anyone had a loved one come out of this to return to the state they were prior to surgery?

My thoughts and prayers to all.

Raina

I have had several surgeries the last few years.We sat the Dr down & explained what can happen with anesthetics in a person with dementia.The Dr used very light sleep meds.& I had no problems...........

Hello Raina, my name is Tom and I want to WELCOME you to this board that is designed for people like you and I! I’m sorry to hear about your problems. It is very important to keep a positive attitude!
My story,
I’m not a professional in this area. I’m a person with AD that serves as a volunteer on the message board. In June of 2008 (age 58) I was diagnosed with Alzheimer’s related dementia. I began visiting this message board in August 2008 and the people have become important to me. I’m sure that you will find a number of supporters here for you.

I will attach a link to a site that will lead you to your local Alzheimer’s Association
Chapter. Those people will be able to assist you with local resources and thoughts to improve your life:
http://www.alz.org/apps/findus.asp

Please call the 24/7 Helpline at
1-800-272-3900 if you have any pressing issues!

Power of Attorney info
http://www.alznyc.org/caregivers/legalplanning.asp

The Alzheimer’s library
http://alzheimers.boomja.com/C...rst-Steps-61311.html

Hello Raina, I'm glad you found these message boards but I'm sorry for the reason you came.

As the care advocate for your elderly hospitalized father who has multiple medical problems complicated with mixed dementia, you will have to take the lead and set the limits if he is too tired or too ill to participate in therapy. You need to strike a balance between what his needs are and what his capabilities are.

You say you don't know what to expect. Here is where you can learn what to expect. The people on these boards are very knowledgeable about dementia and caregiving.

In addition to seeking advice from the Care Consultants, I suggest you also begin to post your questions on the Caregiver Forum. There are many people who visit that board, and they will also advise and support you.

If you have an urgent need, there are Care Consultants available on the 24-hour Alzheimer's Association Helpline at 1-800-272-3900.

In the evenings there are people in the chat room who are available for support.

You are not alone in this journey. There are many here to help you.

Iris L.

Thank you all for responding.

I was so shocked to find that there are so many here dealing with the same thing. My dad did get to come home from the hospital after several very bad reactions to meds. The Ativan, Haldol, Risperdal (sp?), all made him more agitated and increased his hallucinations!
We stopped all his meds and he finally was able to sleep without jerking himself awake with the horrible hallucinations and talking gibberish.

I don't even recognize my father! He just turned 63. They found he didn't have a stroke or anything like that.... they wanted to do a spinal tap to test for menengitis, but that would have required some anesthesia because he couldn't hold still. We said no to that. They said the chances were slim to none that he had menengitis but it was the last thing to rule out. We figured why put him through that and risk more anesthesia problems!!

Since he's been home (with my stepmom), he doesn't enjoy watching TV anymore. I think he can't follow the shows to tell you the truth. He used to work on computers (his job his whole life). We caught him with the hairdryer from the bathroom in the computer room trying to 'fix' something with the computer. It's just so heartbreaking.

And still not one doctor will admit or discuss the relationship of anesthesia to AD. I find that odd. I asked a couple of my father's doctors and all they said was it would be out of his system by now. So frustrating. Obviously something happened where he was able to hold a conversation and take care of himself one week and the next week be a complete mess.

I feel for everyone going through this. I'm trying not to feel guilty about not knowing this sooner! But how could we have known if doctors aren't telling us these things??? I never would have dreamed to look up AD and anesthesia before my dad had his kidney crushed! All this for a kidney stone!

My dad's mom, my grandmother, was diagnosed with AD several years ago and she's doing better than my dad now. Many years ago she had to have heart surgery - they put in a new valve. She's having tests now for shortness of breath, etc. She may have to have heart surgery again and I'm concerned of course. She's almost 90. Obviously you need anesthesia for life/death surgeries. I just don't understand why my dad had such a drastic reaction.

I'm still hoping he'l return to his previous baseline. I never thought I'd say that! Previously I was so frustrated for him - but that was great compared to now. He was so depressed because he knew he couldn't remember what he had for lunch, how to work the remote, etc... I'm sorry, I'm rambling...

I'll read the links that have been posted in this thread. Thank you for those. God bless,

Amy

The propronent Isuflorane in anesthetic is what causes the problem with dementia.............

It seems that there has been more interest in this topic, and I just wanted to review a few of the ideas discussed here. To summarize:

The medical community is very interested and concerned about the effects of anesthesia on a person with AD. This interaction is the subject of ongoing research studies throughout the world. Anesthesia is often necessary for surgical procedures in order to survive or tolerate life. Not only anesthesia, but any change in routine and surroundings can trigger deterioration. Any type of trauma (emotional or physical) can trigger deterioration. Many persons with AD and related dementias will bounce back; others will continue to decline.

Communication between doctor’s and patients’ families is crucial. Always ask if there are any alternatives that exist instead of the recommended procedure. Ask if there is a method of administering anesthesia that my have better post-procedure results for a person with dementia. Find out as much information about your loved one’s particular experience as possible. Speak directly to all the professionals who are involved in treating your loved one. Make the best decision you can with the information you have to favor the quality of life, rather than the length of life. Remember that even when selecting the best option possible, the results may be unpredictable.

Please know that you can discuss your concerns with a Care Consultant by calling our 24-hour helpline @ 1-800-272-3900. Care Consultants are not medically trained, but we can provide reliable information and emotional support.

Sincerely yours,
Kathleen