BMJ: Answer 60 years of questions! Does brain function really decline after surgery?

Half a century later, there is still a lack of consistent evidence on the effects of surgery on the brainAnd because cognitive function would have declined with age, it also posed a challenge to accurately assessing cognitive changes after surgerya major new study published in the British Medical Journal (BMJ) provides strong evidenceAfter tracking more than 7,500 adults for 19 years, the researchers found that surgery (non-minimally invasive) was associated with additional, mild cognitive decline, which averaged more than four months of natural brain aging, after taking into account age-related cognitive changessource: bmJ websitethe study, led by researchers at the University of Wisconsin's Department of Anesthesiology, tracked 7,532 British civil servants between the ages of 45 and 69 from 1997 until 2016, during which they were collected through a health-care database for at least two nights in hospital (excluding clinics) and conducted up to five cognitive assessments, including reasoning, memory, and expressionover an average 13-year follow-up period, the team identified 8,982 critical hospitalizations, including 4,525 surgical procedures (heart, chest, vascular, neurosurgery, etc.), 151 strokes and 4,306 hospitalizations for other medical needs (which can be considered an alternative indicator of other diseases)of age cognitive trajectories for people who were not hospitalized, surgically hospitalized, non-surgically hospitalized and stroked showed that although the risk of cognitive decline after hospitalization was higher compared to those who had not been hospitalized, the potential cognitive risk of surgery was not significant compared to those in other hospitalized patientsthe proportion of people who had not been hospitalized, had surgery and were hospitalized for other medical needs was 2.5%, 5.5% and 12.7%, respectivelyIn contrast, surgical patients had a 130 percent increased risk of cognitive decline and a five-fold increased risk of cognitive impairment in patients admitted to hospital for other medical needsquantified the extent of cognitive decline, and after age, the average decline in cognitive function in patients after surgery was equivalent to 4.2 months of natural brain agingCognitive decline in other hospitalized patients is equivalent to accelerating aging by 1.4 years, especially in stroke patients, equivalent to 13 years of aging!researchers say it also answers some patients' concerns, such as the fact that some stroke patients' families refuse to perform surgery beneficial for recovery for fear of brain damage, when in fact, the disease itself is far more harmful than the potential side effects of surgerythe limitations of this study are so observational that causality cannot be obtained, and that no further specific information about anesthesia is collected, making it difficult to assess the potential impact of anesthesia on long-term cognitive changesBut overall, the team notes, "research data suggest that surgery is associated with long-term cognitive decline, albeit modestly, but this information should be communicated to patients to help them understand and weigh the impact of surgery on health and quality of life." In an editorial published in the, two professors from the University of Cambridge and the University of Newcastle in the UK said: "This study reassures that there has been no significant reduction in patients' cognitive function after surgeryBut further measures are also necessary to change the risk of cognitive decline in surgery and other patient populations "
References Association between major siaai enai admissions and the niny: 19 year follow-up of Whitehall II cohort study BMJ, 10.1136/bmj.l4466 , Carol Brayne, director, et al., (2019) Thethes of the cognitive decline and the ging BMJ, 10.1136/bmj.l4946 Retrieved Aug 8, 2019, from https://