Dementia and Neurologic Syndromes: Distinctions Between Alzheimer’s, Vascular Dementia, and Parkinson’s

Chapter

Abstract

Age-associated neurologic disease can be an important determinant of functional outcome after surgery. Neurologic diseases in the elderly encompass many divergent conditions such as Alzheimer’s disease, Parkinson’s disease with dementia, cerebrovascular disease, and neurologic effects of other systemic disease. The common elements among the dementias are cognitive decline and a secondary impairment in functional outcome. Any stressor, including surgery and anesthesia, can potentially cause acute deterioration in cognition and function.

Keywords

Dopamine Serotonin Oligomer NMDA Acetylcholine 

Suggested Reading

  1. Agronin ME, Agronin ME. Alzheimer disease and other dementias: a practical guide. 2nd ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2008:350. http://www.loc.gov/catdir/enhancements/fy0714/2007017730-d.html.
  2. Allen MH, Currier GW, Carpenter D, Ross RW, Docherty JP, Expert Consensus Panel for Behavioral Emergencies 2005. The expert consensus guideline series. Treatment of behavioral emergencies 2005. J Psychiatr Pract. 2005;11 Suppl 1:5–108; quiz 110–12.Google Scholar
  3. Antonini A, Abbruzzese G, Barone P, et al. COMT inhibition with tolcapone in the treatment algorithm of patients with Parkinson’s disease (PD): relevance for motor and non-motor features. Neuropsychiatr Dis Treat. 2008;4(1):1–9.PubMedCrossRefGoogle Scholar
  4. Avidan MS, Searleman AC, Storandt M, et al. Long-term cognitive decline in older subjects was not attributable to noncardiac surgery or major illness. Anesthesiology. 2009;111(5):964–970.PubMedCrossRefGoogle Scholar
  5. Bedford PD. Adverse cerebral effects of anaesthesia on old people. Lancet. 1955;269(6884): 259–263.PubMedCrossRefGoogle Scholar
  6. Bijker JB, van Klei WA, Vergouwe Y, et al. Intraoperative hypotension and 1-year mortality after noncardiac surgery. Anesthesiology. 2009;111(6):1217–1226.PubMedCrossRefGoogle Scholar
  7. Bohnen N, Warner MA, Kokmen E, Kurland LT. Early and midlife exposure to anesthesia and age of onset of Alzheimer’s disease. Int J Neurosci. 1994;77(3–4):181–185.PubMedCrossRefGoogle Scholar
  8. Brambrink AM, Evers AS, Avidan MS, et al. Isoflurane-induced neuroapoptosis in the neonatal rhesus macaque brain. Anesthesiology. 2010;112(4):834–841.PubMedCrossRefGoogle Scholar
  9. Burton DA, Nicholson G, Hall GM. Anaesthesia in elderly patients with neurodegenerative disorders: special considerations. Drugs Aging. 2004;21(4):229–242.PubMedCrossRefGoogle Scholar
  10. Cohen E, Bieschke J, Perciavalle RM, Kelly JW, Dillin A. Opposing activities protect against age-onset proteotoxicity. Science. 2006;313(5793):1604–1610.PubMedCrossRefGoogle Scholar
  11. Deogaonkar A, Deogaonkar M, Lee JY, Ebrahim Z, Schubert A. Propofol-induced dyskinesias controlled with dexmedetomidine during deep brain stimulation surgery. Anesthesiology. 2006;104(6):1337–1339.PubMedCrossRefGoogle Scholar
  12. Deogaonkar M, Subramanian T. Pathophysiological basis of drug-induced dyskinesias in Parkinson’s disease. Brain Res Brain Res Rev. 2005;50(1):156–168.PubMedCrossRefGoogle Scholar
  13. Fodale V, Quattrone D, Trecroci C, Caminiti V, Santamaria LB. Alzheimer’s disease and anesthesia: implications for the central cholinergic system. Br J Anaesth. 2006;97(4):445–452.PubMedCrossRefGoogle Scholar
  14. Gasparini M, Vanacore N, Schiaffini C, et al. A case-control study on Alzheimer’s disease and exposure to anesthesia. Neurol Sci. 2002;23(1):11–14.PubMedCrossRefGoogle Scholar
  15. Johnson T, Monk T, Rasmussen LS, et al. Postoperative cognitive dysfunction in middle-aged patients. Anesthesiology. 2002;96(6):1351–1357.PubMedCrossRefGoogle Scholar
  16. Kalenka A, Schwarz A. Anaesthesia and Parkinson’s disease: how to manage with new therapies? Curr Opin Anaesthesiol. 2009;22(3):419–424.PubMedCrossRefGoogle Scholar
  17. Kertai MD, Pal N, Palanca BJ, et al. Association of perioperative risk factors and cumulative duration of low bispectral index with intermediate-term mortality after cardiac surgery in the B-Unaware Trial. Anesthesiology. 2010;112(5):1116–1127.PubMedCrossRefGoogle Scholar
  18. Korczyn AD, Reichmann H, Boroojerdi B, Hack HJ. Rotigotine transdermal system for perioperative administration. J Neural Transm. 2007;114(2):219–221.PubMedCrossRefGoogle Scholar
  19. Krauss JK, Akeyson EW, Giam P, Jankovic J. Propofol-induced dyskinesias in Parkinson’s disease. Anesth Analg. 1996;83(2):420–422.PubMedGoogle Scholar
  20. Kurz A, Perneczky R. Neurobiology of cognitive disorders. Curr Opin Psychiatry. 2009;22(6):546–551.PubMedCrossRefGoogle Scholar
  21. Lewis MC, Barnett SR. Postoperative delirium: the tryptophan dysregulation model. Med Hypotheses. 2004;63(3):402–406.PubMedCrossRefGoogle Scholar
  22. Lewitt PA. Levodopa for the treatment of Parkinson’s disease. N Engl J Med. 2008;359(23): 2468–2476.PubMedCrossRefGoogle Scholar
  23. Liang G, Ward C, Peng J, Zhao Y, Huang B, Wei H. Isoflurane causes greater neurodegeneration than an equivalent exposure of sevoflurane in the developing brain of neonatal mice. Anesthesiology. 2010;112(6):1325–1334.PubMedCrossRefGoogle Scholar
  24. Lin SH, Chen TY, Lin SZ, et al. Subthalamic deep brain stimulation after anesthetic inhalation in Parkinson disease: a preliminary study. J Neurosurg. 2008;109(2):238–244.PubMedCrossRefGoogle Scholar
  25. Liu SJ, Gasperini R, Foa L, Small DH. Amyloid-beta Decreases Cell-Surface AMPA Receptors by Increasing Intracellular Calcium and Phosphorylation of GluR2. J Alzheimers Dis. 2010.Google Scholar
  26. McDonagh DL, Mathew JP, White WD, et al. Cognitive function after major noncardiac surgery, apolipoprotein E4 genotype, and biomarkers of brain injury. Anesthesiology. 2010;112(4): 852–859.PubMedCrossRefGoogle Scholar
  27. Moller JT, Cluitmans P, Rasmussen LS, et al. Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study of Post-Operative Cognitive Dysfunction. Lancet. 1998;351(9106):857–861.PubMedCrossRefGoogle Scholar
  28. Monk TG, Weldon BC, Garvan CW, et al. Predictors of cognitive dysfunction after major noncardiac surgery. Anesthesiology. 2008;108(1):18–30.PubMedCrossRefGoogle Scholar
  29. Newman S, Stygall J, Hirani S, Shaefi S, Maze M. Postoperative cognitive dysfunction after ­noncardiac surgery: a systematic review. Anesthesiology. 2007;106(3):572–590.PubMedCrossRefGoogle Scholar
  30. Nicholson G, Pereira AC, Hall GM. Parkinson’s disease and anaesthesia. Br J Anaesth. 2002;89(6): 904–916.PubMedCrossRefGoogle Scholar
  31. Nutt JG, Chung KA, Holford NH. Dyskinesia and the antiparkinsonian response always temporally coincide: a retrospective study. Neurology. 2010;74(15):1191–1197.PubMedCrossRefGoogle Scholar
  32. Peleg S, Sananbenesi F, Zovoilis A, et al. Altered histone acetylation is associated with age-dependent memory impairment in mice. Science. 2010;328(5979):753–756.PubMedCrossRefGoogle Scholar
  33. Price CC, Garvan CW, Monk TG. Type and severity of cognitive decline in older adults after noncardiac surgery. Anesthesiology. 2008;108(1):8–17.PubMedCrossRefGoogle Scholar
  34. Querfurth HW, LaFerla FM. Alzheimer’s disease. N Engl J Med. 2010;362(4):329–344.PubMedCrossRefGoogle Scholar
  35. Rozet I, Muangman S, Vavilala MS, et al. Clinical experience with dexmedetomidine for implantation of deep brain stimulators in Parkinson’s disease. Anesth Analg. 2006;103(5):1224–1228.PubMedCrossRefGoogle Scholar
  36. Salthouse TA. Implications of within-person variability in cognitive and neuropsychological functioning for the interpretation of change. Neuropsychology. 2007;21(4):401–411.PubMedCrossRefGoogle Scholar
  37. Schrag A. Entacapone in the treatment of Parkinson’s disease. Lancet Neurol. 2005;4(6): 366–370.PubMedCrossRefGoogle Scholar
  38. Sieber FE, Gottshalk A, Zakriya KJ, Mears SC, Lee H. General anesthesia occurs frequently in elderly patients during propofol-based sedation and spinal anesthesia. J Clin Anesth. 2010;22(3):179–183.PubMedCrossRefGoogle Scholar
  39. Sieber FE, Zakriya KJ, Gottschalk A, et al. Sedation depth during spinal anesthesia and the development of postoperative delirium in elderly patients undergoing hip fracture repair. Mayo Clin Proc. 2010;85(1):18–26.PubMedCrossRefGoogle Scholar
  40. Small DH. Dysregulation of calcium homeostasis in Alzheimer’s disease. Neurochem Res. 2009;34(10):1824–1829.PubMedCrossRefGoogle Scholar
  41. Small DH, Gasperini R, Vincent AJ, Hung AC, Foa L. The role of Abeta-induced calcium dysregulation in the pathogenesis of Alzheimer’s disease. J Alzheimers Dis. 2009;16(2):225–233.PubMedGoogle Scholar
  42. Stotz M, Thummler D, Schurch M, Renggli JC, Urwyler A, Pargger H. Fulminant neuroleptic malignant syndrome after perioperative withdrawal of antiParkinsonian medication. Br J Anaesth. 2004;93(6):868–871.PubMedCrossRefGoogle Scholar
  43. Tabet N, Howard R. Non-pharmacological interventions in the prevention of delirium. Age Ageing. 2009;38(4):374–379.PubMedCrossRefGoogle Scholar
  44. Tabet N, Howard R. Pharmacological treatment for the prevention of delirium: review of current evidence. Int J Geriatr Psychiatry. 2009;24(10):1037–1044.PubMedCrossRefGoogle Scholar
  45. Wei H, Xie Z. Anesthesia, calcium homeostasis and Alzheimer’s disease. Curr Alzheimer Res. 2009;6(1):30-35.PubMedCrossRefGoogle Scholar
  46. Williams-Russo P, Sharrock NE, Mattis S, et al. Randomized trial of hypotensive epidural anesthesia in older adults. Anesthesiology. 1999;91(4):926–935.PubMedCrossRefGoogle Scholar
  47. Williams-Russo P, Sharrock NE, Mattis S, et al. Randomized trial of hypotensive epidural anesthesia in older adults. Anesthesiology. 1999;91(4):926–935.PubMedCrossRefGoogle Scholar
  48. Williams-Russo P, Sharrock NE, Mattis S, Szatrowski TP, Charlson ME. Cognitive effects after epidural vs general anesthesia in older adults. A randomized trial. JAMA. 1995;274(1):44–50.Google Scholar
  49. Wu CL, Hsu W, Richman JM, Raja SN. Postoperative cognitive function as an outcome of regional anesthesia and analgesia. Reg Anesth Pain Med. 2004;29(3):257–268.PubMedGoogle Scholar
  50. Yang H, Liang G, Hawkins BJ, Madesh M, Pierwola A, Wei H. Inhalational anesthetics induce cell damage by disruption of intracellular calcium homeostasis with different potencies. Anesthesiology. 2008;109(2):243–250.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Anesthesiology and Critical Care MedicineThe Johns Hopkins Hospital and Johns Hopkins Bayview Medical CenterBaltimoreUSA

Personalised recommendations