Clin Psychopharmacol Neurosci.  2025 Feb;23(1):65-75. 10.9758/cpn.24.1181.

The Risk of Dementia after Anesthesia Differs according to the Mode of Anesthesia and Individual Anesthetic Agent

• Lee SH
• Hyung WSW
• Seo S
• Kim J
• Han C
• Choi KY
• Youn H
• Jeong HG

• KMID: 2565661
• DOI: http://doi.org/10.9758/cpn.24.1181

Abstract

Objective
Multiple cohort studies have investigated the potential link between anesthesia and dementia. However, mixed findings necessitate closer examination. This study aimed to investigate the association between anesthesia exposure and the incidence of dementia, considering different anesthesia types and anesthetic agents.
Methods
This nationwide cohort study utilized data from the South Korean Health Insurance Review and Assessment Service database, covering 62,541 participants, to investigate the correlation between anesthesia exposure and dementia incidence.
Results
Results revealed an increased risk of dementia in individuals who underwent general (hazard ratio [HR], 1.318; 95% confidence interval [CI], 1.061−1.637) or regional/local anesthesia (HR, 2.097; 95% CI, 1.887−2.329) compared to those who did not. However, combined general and regional/local anesthesia did not significantly increase dementia risk (HR, 1.097; 95% CI, 0.937−1.284). Notably, individual anesthetic agents exhibited varying risks; desflurane and midazolam showed increased risks, whereas propofol showed no significant difference.
Conclusion
This study provides unique insights into the nuanced relationship between anesthesia, individual anesthetic agents, and the incidence of dementia. While confirming a general association between anesthesia exposure and dementia risk, this study also emphasizes the importance of considering specific agents. These findings under-score the need for careful evaluation and long-term cognitive monitoring after anesthesia.

Keyword

Dementia; Anesthesia; Postoperative complications; Postoperative cognitive complications; Cohort studies; Incidence