Impact of Anesthesia on the Cognitive Functioning of the Elderly

1997 ◽  
Vol 9 (3) ◽  
pp. 309-326 ◽  
Author(s):  
Karen Ritchie ◽  
Catherine Polge ◽  
Guilhem de Roquefeuil ◽  
Michel Djakovic ◽  
Bernard Ledesert
Keyword(s):  
Cognitive Impairment ◽  
Senile Dementia ◽  
Significant Proportion ◽  
The Elderly ◽  
Cognitive Disorder ◽  
Incidence Rates ◽  
Bibliographic Databases ◽  
Elderly Subjects ◽  
Elderly Persons ◽  
Anesthetic Agents

Exposure to general anesthesia has been suggested as a possible cause of long-term cognitive impairment in elderly subjects. The present study reviews the literature in this field in order to describe postoperative cognitive impairment in elderly populations, to determine to what extent this may be attributed to anesthetic agents, and to consider evidence of a causal relationship between anesthesia and onset of senile dementia. A systematic literature search was conducted using five bibliographic databases (PASCAL, Medline, Excerpta Medica, Psychological Abstracts, and Science Citation Index). Significant cognitive dysfunction was found to be common in elderly persons 1 to 3 days after surgery, but reports of longer-term impairment are inconsistent due to the heterogeneity of the procedures used and populations targeted in such studies. Incidence rates vary widely according to type of surgery, suggesting that factors other than anesthesia explain a significant proportion of the observed variance. Anesthesia appears to be associated with longer-term cognitive disorder and the acceleration of senile dementia, but only in a small number of cases, suggesting the existence of other interacting etiological factors.

A Typology of Sub-Clinical Senescent Cognitive Disorder

1996 ◽  
Vol 168 (4) ◽  
pp. 470-476 ◽  
Author(s):  
Karen Ritchie ◽  
Didier Leibovici ◽  
Bernard Ledésert ◽  
Jacques Touchon
Keyword(s):  
Cluster Analysis ◽  
Logistic Regression ◽  
Cognitive Impairment ◽  
Memory Impairment ◽  
Senile Dementia ◽  
Cognitive Disorder ◽  
Elderly Persons ◽  
One Year ◽  
Incident Cases ◽  
Ageing Populations

BackgroundCognitive impairment without dementia is commonly observed in ageing populations. The present study aims to describe types of impairment and evolution over a one-year period.MethodThree hundred and ninety-seven normal French elderly persons demonstrating recent, observable change in cognitive performance were examined annually using a computerised cognitive examination.ResultsFive subtypes were differentiated by cluster analysis. Two of the groups were predicted by logistic regression to be at high risk of senile dementia. Of 16 incident cases of senile dementia diagnosed in the following year, 13 were found to have derived from these two groups. The typology was also found to be useful in the description of age-associated memory impairment.ConclusionsSubclinical cognitive impairment was found to not constitute a unitary phenomenon and heterogeneous subgroups could be differentiated. The concept of ‘normality’ in elderly cohorts is reconsidered in the light of these findings.

scholarly journals Characteristics of Lower Limb Muscle Activity in Elderly Persons After Ergometric Exercise

2020 ◽  
Vol 6 ◽  
pp. 233372142097980
Author(s):  
Kenichi Kaneko ◽  
Hitoshi Makabe ◽  
Kazuyuki Mito ◽  
Kazuyoshi Sakamoto ◽  
Yoshiya Kawanori ◽  
...  
Keyword(s):  
Lower Limb ◽  
Muscle Activity ◽  
The Elderly ◽  
Elderly Subjects ◽  
Elderly Persons ◽  
Lower Limb Muscle ◽  
Limb Muscle ◽  
Lower Limb Muscles ◽  
The Mean ◽  
Young Subjects

This study examined the characteristics of lower limb muscle activity in elderly persons after ergometric pedaling exercise for 1 month. To determine the effect of the exercise, surface electromyography (SEMG) of lower limb muscles was subjected to Daubechies-4 wavelet transformation, and mean wavelet coefficients were compared with the pre-exercise coefficients and the post-exercise coefficients in each wavelet level. The characteristics of muscle activity after pedaling exercise were also compared between the elderly subjects and young subjects. For the elderly subjects, the mean wavelet coefficients were significantly decreased in the tibialis anterior and the gastrocnemius medialis at wavelet levels of 3, 4, and 5 (125–62.5, 62.5–31.25, and 31.25–15.625 Hz, respectively), by pedaling exercise. However, the mean power of wavelet levels of 2 and 3 (250–125 and 125–62.5 Hz) within the rectus femoris and the biceps femoris were significantly increased in the young subjects. The effect of pedaling exercise is different from the effects of heavy-resistance training. It was suggested that the muscle coordination, motor unit (MU) firing frequency, and firing fiber type of lower limb muscles are changed with the different characteristics between elderly and young persons by pedaling exercise for 1 month.

scholarly journals Update on the Neurobiology of Vascular Cognitive Impairment: From Lab to Clinic

2020 ◽  
Vol 21 (8) ◽  
pp. 2977 ◽  
Author(s):  
Luisa Vinciguerra ◽  
Giuseppe Lanza ◽  
Valentina Puglisi ◽  
Francesco Fisicaro ◽  
Manuela Pennisi ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Disease Process ◽  
The Elderly ◽  
Vascular Cognitive Impairment ◽  
Cognitive Disorder ◽  
Vascular Lesion ◽  
Adaptive Plasticity ◽  
Disease Modifying Drugs ◽  
Neurophysiological Studies ◽  
Degenerative Dementia

In the last years, there has been a significant growth in the literature exploring the pathophysiology of vascular cognitive impairment (VCI). As an “umbrella term” encompassing any degree of vascular-related cognitive decline, VCI is deemed to be the most common cognitive disorder in the elderly, with a significant impact on social and healthcare expenses. Interestingly, some of the molecular, biochemical, and electrophysiological abnormalities detected in VCI seem to correlate with disease process and progression, eventually promoting an adaptive plasticity in some patients and a maladaptive, dysfunctional response in others. However, the exact relationships between vascular lesion, cognition, and neuroplasticity are not completely understood. Recent findings point out also the possibility to identify a panel of markers able to predict cognitive deterioration in the so-called “brain at risk” for vascular or mixed dementia. This will be of pivotal importance when designing trials of disease-modifying drugs or non-pharmacological approaches, including non-invasive neuromodulatory techniques. Taken together, these advances could make VCI a potentially preventable cause of both vascular and degenerative dementia in late life. This review provides a timely update on the recent serological, cerebrospinal fluid, histopathological, imaging, and neurophysiological studies on this “cutting-edge” topic, including the limitations, future perspectives and translational implications in the diagnosis and management of VCI patients.

scholarly journals Impact of cognitive performance on the functional capacity of an elderly population in Natal, Brazil

2008 ◽  
Vol 66 (4) ◽  
pp. 809-813 ◽  
Author(s):  
Keithlen Cruz Moreira de Castro ◽  
Ricardo Oliveira Guerra
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Performance ◽  
Functional Capacity ◽  
Elderly Population ◽  
Population Sample ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Elderly Persons ◽  
Cross Sectional ◽  
State Examination

Functional incapacity and cognitive impairment are conditions related to the process of human aging. Cognitive impairment is considered an important predicitve factor for functional impairment in elderly populations. This cross-sectional study analyzes the association between cognitive performance and functional capacity in an elderly population sample in Natal, Brazil. A total of 213 elderly persons were assessed by the BOAS Multidimensional Questionnaire (Brazil Old Age Schedule) and the Mini-Mental State Examination (MMSE). The results of multivariate analysis and linear regression showed that age and schooling level are factors associated with cognitive performance in the elderly of this study. The final explicative model, elaborated by logistic regression, found that cognitive performance was the only predicitve variable of functional incapacity for the activities of daily living even when adjusted for sociodemographic variables.

scholarly journals VH3 Antibody Response to Immunization with Pneumococcal Polysaccharide Vaccine in Middle-Aged and Elderly Persons

2011 ◽  
Vol 18 (3) ◽  
pp. 362-366 ◽  
Author(s):  
Jose A. Serpa ◽  
Josemon Valayam ◽  
Daniel M. Musher ◽  
Roger D. Rossen ◽  
Liise-anne Pirofski ◽  
...  
Keyword(s):  
The Elderly ◽  
Polysaccharide Vaccine ◽  
Antibody Responses ◽  
Elderly Subjects ◽  
Enzyme Linked Immunosorbent Assay ◽  
Elderly Persons ◽  
Pneumococcal Polysaccharide Vaccine ◽  
Elderly Adults ◽  
Middle Aged ◽  
Idiotypic Antibody

ABSTRACTPneumococcal disease continues to cause substantial morbidity and mortality among the elderly. Older adults may have high levels of anticapsular antibody after vaccination, but their antibodies show decreased functional activity. In addition, the protective effect of the pneumococcal polysaccharide vaccine (PPV) seems to cease as early as 3 to 5 years postvaccination. Recently, it was suggested that PPV elicits human antibodies that use predominantly VH3 gene segments and induce a repertoire shift with increased VH3 expression in peripheral B cells. Here we compared VH3-idiotypic antibody responses in middle-aged and elderly subjects receiving PPV as initial immunization or revaccination. We studied pre- and postvaccination sera from 36 (18 vaccine-naïve and 18 previously immunized subjects) middle-aged and 40 (22 vaccine-naïve and 18 previously immunized subjects) elderly adults who received 23-valent PPV. Concentrations of IgGs to four individual serotypes (6B, 14, 19F, and 23F) and of VH3-idiotypic antibodies (detected by the monoclonal antibody D12) to the whole pneumococcal vaccine were determined by enzyme-linked immunosorbent assay (ELISA). PPV elicited significant IgG and VH3-idiotypic antibody responses in middle-aged and elderly subjects, regardless of whether they were vaccine naïve or undergoing revaccination. Age did not influence the magnitude of the antibody responses, as evidenced by similar postvaccination IgG and VH3 antibody levels in both groups, even after stratifying by prior vaccine status. Furthermore, we found similar proportions (around 50%) of elderly and middle-aged subjects experiencing 2-fold increases in VH3 antibody titers after vaccination. Age or repeated immunization does not appear to affect the VH3-idiotypic immunogenicity of PPV among middle-aged and elderly adults.

Anti-Cholinergic Drugs and Memory: the Effects of Benzhexol on Memory in a Group of Geriatric Patients

1982 ◽  
Vol 140 (5) ◽  
pp. 470-472 ◽  
Author(s):  
G. Potamianos ◽  
J. M. Kellett
Keyword(s):  
Short Story ◽  
Senile Dementia ◽  
Digit Span ◽  
Word List ◽  
The Elderly ◽  
Learning Task ◽  
Elderly Subjects ◽  
Double Blind ◽  
Associate Learning ◽  
Immediate Recall

SummaryA double blind trial on the effects of 2 mg of benzhexol on memory was performed on thirteen elderly subjects without cognitive impairment. The tests given 90 minutes after the drug or placebo involved learning a list of ten words, a paired-associate learning task, learning a short story and a test of digit span. Subjects were asked to recall the word list one minute after an interfering task, and 6 items from the story directly. Digit span involved immediate recall and the paired learning was measured by the number of trials necessary to learn. All tests were significantly impaired by the benzhexol except for digit span. This suggests that muscarinic blocking drugs should be avoided in the elderly, as they mimic the memory deficits found in senile dementia of Alzheimer type.

Computed Tomography in the Elderly 2. Senile Dementia: Diagnosis and Functional Impairment

1980 ◽  
Vol 136 (3) ◽  
pp. 256-269 ◽  
Author(s):  
Robin J. Jacoby ◽  
Raymond Levy
Keyword(s):  
Senile Dementia ◽  
Clinical Signs ◽  
Cerebral Atrophy ◽  
The Elderly ◽  
Cognitive Test ◽  
Cortical Atrophy ◽  
Elderly Subjects ◽  
Computed Tomographic ◽  
Dementia Patients ◽  
Ct Data

SummaryClinical, psychometric and computed tomographic (CT) data are presented on three groups of elderly subjects: 50 normals, 40 patients with senile dementia and 41 suffering from affective disorder. Demented subjects showed significantly more CT evidence of cerebral atrophy than non-demented subjects, but there was considerable overlap. Although patients with a history or clinical signs of cerebral infarction were specifically excluded, such infarcts were found more often in CT scans of the dementia subjects than in the others, particularly when the diastolic blood pressure was raised. When correlating cognitive impairment with CT changes, ventricular size emerged as more important in the dementia patients, in contrast to the controls, in whom cortical atrophy was related to lower scores on a cognitive test. Other interesting findings included an inverse relationship between cortical atrophy and paranoid delusions.

scholarly journals Features associated with cognitive impairment and dementia in a community-based sample of illiterate elderly aged 75+ years: The Pietà study

2014 ◽  
Vol 8 (2) ◽  
pp. 126-131 ◽  
Author(s):  
Henrique Cerqueira Guimarães ◽  
Jorge Luiz Cascardo ◽  
Rogério Gomes Beato ◽  
Maira Tonidandel Barbosa ◽  
Thais Helena Machado ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Protective Factor ◽  
Brain Aging ◽  
Apoe Genotype ◽  
The Elderly ◽  
Elderly Subjects ◽  
Community Based ◽  
Cross Sectional ◽  
E4 Allele ◽  
Ischemic Attack

ABSTRACT A higher level of educational attainment constitutes a protective factor against cognitive decline in the elderly. Nevertheless, the elements underpinning this association are yet not fully understood. Objective: The primary aim of this study was to compare cognitively impaired illiterate elderly subjects with cognitively preserved counterparts, according to demographics, comorbidities, lifetime habits and APOE genotype. Methods: This is a cross-sectional analysis of the illiterate subset of participants (n=174) from the Pietà study, a community-based survey of successful brain aging conducted in Caeté (MG), Brazil. Subjects were categorized into three diagnostic groups: cognitively normal (CN), cognitive impairment no-dementia (CIND) and dementia. The groups were then compared according to selected variables. Results: Subjects with dementia were older and had an increased prevalence of reported stroke or transient ischemic attack. The three groups did not differ in relation to demographics, prevalence of comorbidities, socioeconomic level, previous occupation profile and APOE-e4 allele frequency. Qualitatively evaluated lifetime habits, such as alcohol consumption, smoking and physical activity engagement were also similar across groups. Conclusion: No associations were found between cognitive impairment/dementia and the variables evaluated in this community-based sample of illiterate elderly.

Mediators of Perceptions of Stress among Community-Based Elders

1989 ◽  
Vol 65 (1) ◽  
pp. 307-314E ◽  
Author(s):  
P. S. Fry
Keyword(s):  
Life Events ◽  
Stressful Life Events ◽  
The Elderly ◽  
Current Theory ◽  
Daily Hassles ◽  
Elderly Subjects ◽  
Elderly Persons ◽  
Mediating Effects ◽  
Community Based ◽  
The Relationship

Research focusing on the relationship between the frequency of stressful life events and perceptions of stress among the aged has increased considerably over the past few decades. The present research focused on expanding the simple life-events/stress-perceptions paradigm by including several other variables that have previously been assumed to be associated with an increase in perceptions of stress among elderly persons. More specifically, the present investigation concerned evaluation of mediating effects of levels of social support, problem-solving, and frequency of daily hassles on the perceptions of stress by elderly individuals. A prospective design evaluated over a 24-mo. period was used to assess the mediating effects. A conceptual model of mediating effects was tested using path analysis statistical techniques on data from a sample of 80 community-based elderly volunteers. The postulated model accounted for 53% of the variance associated with the prediction of perceptions of stress among the elderly subjects. Implications for current theory and research in the study of mediating variables in the stress symptomatology of older adults are discussed.

S194 – Pharyngeal Thickness in Young and Elderly Normal Subjects

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P140-P141
Author(s):  
Shervin Aminpour ◽  
Scott Fuller ◽  
Leonard Rebecca ◽  
Peter C Belafsky
Keyword(s):  
Wall Thickness ◽  
Posterior Pharyngeal Wall ◽  
Normal Subjects ◽  
The Elderly ◽  
Elderly Subjects ◽  
Elderly Persons ◽  
Pharyngeal Wall ◽  
Posterior Pharyngeal Wall Thickness ◽  
Normal Adults ◽  
Anterior Posterior

Objectives Previous research has demonstrated pharyngeal size and constriction differences between normal young and elderly adults. Evidence suggests that the pharynx of elderly subjects dilates and does not constrict as well as younger persons. The distance between the larynx and the hyoid at rest is greater in the elderly, as is the anterior-posterior width of the pharynx maximally expanded. We have noticed that the pharynx of elderly persons appears to atrophy with age. The purpose of this investigation was to compare pharyngeal wall thickness in young vs. elderly persons. Methods Videofluoroscopic swallow studies were performed on 82 normal adults under the age of 65 years and on 89 normal adults over the age of 65. Measures of posterior pharyngeal wall thickness (PWT) were determined at rest and at the same point during maximum constriction of the pharynx on a 20-cc bolus swallow. Data were compared with the independent samples t-test. Results No gender differences were identified for the younger or elderly groups. Mean PWT at rest was .40cm (± .08) for the younger group and 30cm (± .08) for the elderly (p <0.01). Pharyngeal wall thickness measured at the same point during maximum constriction was 1.08cm (±38) for the younger group and .92cm (±36) for the elderly (p <0.01). Conclusions Data from the current study suggest that the posterior pharyngeal wall is thinner in elderly individuals older than 65 as compared to younger adults. These differences may help explain differences in pharyngeal strength, swallowing efficiency, and safety in the elderly.

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