• Juraj Sprung, Phillip J Schulte, David S Knopman, Michelle M Mielke, Ronald C Petersen, Toby N Weingarten, David P Martin, Andrew C Hanson, Darrell R Schroeder, and David O Warner.
• Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA. Electronic address: sprung.juraj@mayo.edu.
• Alzheimers Dement. 2019 Oct 1; 15 (10): 1243-1252.

IntroductionOur aim was to examine whether surgery with regional anesthesia (RA) is associated with accelerated long-term cognitive decline comparable with that previously reported after general anesthesia (GA).MethodsLongitudinal cognitive function was analyzed in a cohort of 1819 older adults. Models assessed the rate of change in global and domain-specific cognition over time in participants exposed to RA or GA.ResultsWhen compared with those unexposed to anesthesia, the postoperative rate of change of the cognitive global z-score was greater in those exposed to both RA (difference in annual decline of -0.041, P = .011) and GA (-0.061, P < .001); these rates did not differ. In analysis of the domain-specific scores, an accelerated decline in memory was observed after GA (-0.065, P < .001) but not RA (-0.011, P = .565).ConclusionsOlder adults undergoing surgery with RA experience decline of global cognition similar to those receiving GA; however, memory was not affected.Copyright © 2019 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

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