Frequently, I talk with people who have gotten their elderly parent home from a hospital stay, expecting an improvement in health, and found that they have deteriorated mentally - sometimes significantly. They ask, "Will this go away?"
Obviously, each case is different, but it's certainly an issue that needs to be addressed. Sometimes a hospital stay can be so disorienting that an elder will sink into a confused state, even though no sign of infection or other physical reason seems evident. Some recover, but some don't seem to ever get back to where they were prior to the hospital stay.
Is delirium the wrong word for this? Perhaps, by some definitions, but it is one that has been used by scientists as they've looked into why an elder can go home mentally worse off than they were before the hospitalization. If there has been an anesthetic used, as is often the case, there seems to be more of a chance that the elder will suffer mentally. While anesthesia is meant to wear off, causing no side effects once processed by the body, this doesn't seem to be the case with many elders.
In an article titled, "Inhaling Alzheimer's? Hazy Picture Links Anesthesia, AD," scientists address this issue, though the end result is that there is still much to learn. According to the article, in some cases the anesthetic seems to push elders closer to Alzheimer's disease.
The article quotes researcher Roderic Eckenhoff, of the University of Pennsylvania in Philadelphia, as saying, "Although cell culture and animal experiments show common anesthetics can cause amyloid-β production and apoptosis, the possible connection in people is hazier."
Eckenhoff and his colleagues have found evidence that not everyone totally recovers from their hospital experience worrisome enough that they plan to do multi-site clinical studies to follow up on what they've learned.
Some of the scientists think certain drugs are more harmful than others, and are unofficially suggesting modifying treatment of elderly patients. There will have to be much more research into individual drugs before any official recommendations are changed, but I find it significant that, according to the article, the researchers have drawn a conclusion that, "...for a person already at risk for AD-maybe because of an ApoE4 genotype or mild cognitive impairment-anesthesia may be the final insult that launches the brain into Alzheimer's mode."
What is most interesting about the article, in my view, is that these researchers are looking at their own parents and making recommendations about the type of anesthetic they want them to avoid. One is the commonly used drug isoflurane. To me, if these learned people are suspicious enough of a drug that they warn family and friends against it, as this article implies, it's something to consider if you know you have an elder going in for surgery, or if you are at risk for early-onset Alzheimer's and need surgery of some kind yourself.. You might want to click on the link to the article and see what you think.
Published On: August 13, 2009