Objective: Postoperative cognitive dysfunction is common among the elderly. These changes may even be so severe that some elderly people actually become demented after undergoing an operation. There was minimal evidence to support continued postoperative cognitive decline beyond 5 years or more. The aim of this study is to explore whether general anesthesia (GA) impact the incidence of Parkinson’s disease (PD) in nationwide population.

Background: Parkinson’s disease (PD) is one of the important diseases among older population and leads to disability. The exact mechanism of PD is variant. Whether general anesthesia (GA) is a potential risk factor for the development of PD is controversial. Therefore, this study aimed to evaluate the association between previous exposure to different types of GA and the incidence of PD.

Methods: Using claims data of 1,000,000 insured residents covered in the national health insurance, we enrolled 4,931 newly diagnosed dementia cases with age more than 50 years-old in 2005-2009. The control group of 19,720 individuals without PD was matched for age, gender, and index date. GA were categorized as three subtypes, including endotracheal tube intubation general anesthesia (ETGA), intravenous injection general anesthesia (IVGA) or intramuscular injection general anesthesia (IMGA), and heavy sedation. Multivariate logistic regression model was used for analyses.

Results: Individual with ETGA (odds ratio; OR=1.31, 95% CI=1.22-1.40) was significantly increased PD risk. There were significantly interactions of subjects with receiving ETGA and having depression, or diabetes, or hypertension, or stroke, or atherosclerosis, alcoholism and head injury for PD risk. No association between IVGA or IMGA or heavy sedation and increased risk of PD was observed.

Conclusions: A history of previous exposure to GA is associated with an increasing risk of PD. In addition, there were significantly interaction of subjects receiving ETGA and having co-morbidities, such as depression, stroke, hypertension, diabetes, atherosclerosis and alcoholism for PD risk.

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2.    Obeso, J.A., et al., Functional organization of the basal ganglia: therapeutic implications for Parkinson’s disease. Mov Disord, 2008. 23 Suppl 3: p. S548-59.

3.    Lesage, S. and A. Brice, Parkinson’s disease: from monogenic forms to genetic susceptibility factors. Hum Mol Genet, 2009. 18(R1): p. R48-59.

4.    Jevtovic-Todorovic, V., et al., Early exposure to common anesthetic agents causes widespread neurodegeneration in the developing rat brain and persistent learning deficits. J Neurosci, 2003. 23(3): p. 876-82.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/general-anesthesia-and-parkinsons-disease/