Medical, Research

Dementia risk raised after general anaesthetic for over 65s…

According to a study, having a general anaesthetic in later life could raise the risk of developing dementia by a third.

Brain changes caused by the anaesthetic could lead to Alzheimer’s within a few years in some patients, warn researchers.

It has long been known that having a general anaesthetic may result in poor brain functioning straight after an operation, especially in the elderly.

In most cases the side-effect is temporary, although many relatives complain their loved ones were ‘never quite the same’ after a major operation.

There has already been debate whether there is a link with dementia in the long term. Last year research on mice suggested cognitive function could be impaired in ways similar to changes caused by Alzheimer’s.

The latest study, though, found a 35 per cent higher risk of dementia in older people having surgery under general anaesthetic compared to local anaesthetic.

Extra cases of dementia emerged among patients up to eight years later, according to the study by the French Institute of Health and Medical Research and the University of Bordeaux.

Scientists in the UK say there is rarely an alternative to general anaesthetic if older patients need major surgery, but they do accept that more research could help identify those at risk.

Researchers’ analysed medical data of French people aged 65 and over living in three cities. They were interviewed at the start of the study and subsequently two, four, seven and ten years after.

Each examination included a complete assessment of cognitive functioning and systematic screening for dementia.

After two years, researchers started asking 7,008 participants whether they had undergone a general or local anaesthetic since the last follow-up. The data was adjusted to take account of factors such as socioeconomic status and other medical conditions which might raise the risk of dementia.

Altogether 19 per cent had undergone a general anaesthetic and 14 per cent had been treated under a local anaesthetic.

A total of 632 people – nine per cent – developed dementia over the eight subsequent years of the study, most of whom were diagnosed with Alzheimer’s.

The research was presented on 31 May, 2013, at Euroanaesthesia, the annual congress of the European Society of Anaesthesiology in Barcelona.

The researchers said the change in the brain that causes cognitive dysfunction after major surgery is the same as the one that causes dementia – when clumps of a protein stick to brain cells, affecting memory, mood and behaviour.

Several studies have suggested that some anaesthetic drugs could promote inflammation of brain tissue in a way that is characteristic of dementia.

Another theory is that insufficient oxygen to the brain may have an effect in vulnerable patients.

Alzheimer’s Research UK, a charity, said that we need to await the full peer-reviewed publication before fully interpreting the results.

Research into the impact of anaesthetics on dementia is challenging. Dementia is caused by several brain diseases, many of which arise from a complex mix of genetic and environmental factors.

Understanding these risk factors is vital, but research into dementia remains poorly funded compared to other diseases. We need to see sustained funding to unravel the full complexity of a condition that is often described as ‘devastating’.

Dementia Signs

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Syria

Syria’s war and diplomacy: A response…

In response to an article that appeared on the website of The Economist, dated June 1, 2013, entitled: ‘Syria’s war and diplomacy – Argument and Arms’

THE EFFECTIVE BLOCKING by Britain and France by other European nations to extend the weapons embargo on Syria is a diplomatic victory, and, is being portrayed as a tool aimed at pressurising Bashar al-Assad to negotiate an end to the conflict. Britain says it has no immediate intention to ship arms to Syria until diplomacy has been given a chance.

The decision to allow movement of arms and weapons has opened a possible route for Britain and France (either through Turkey or more likely via Jordan) which have been leading the charge in the West for more support to be given to the Syrian opposition, to act unilaterally should they decide to do so. Other European countries fear that any arms sent to the rebels could fall into the hands of Islamist extremists and lead to a wider and regional spill-over of the conflict. Britain and France have agreed not to deliver any weapons until at least August 1, to give more time to international attempts at brokering a peace deal and not to imperil the prospects of a US/Russian-brokered peace conference scheduled to take place in Geneva in June. The Obama administration has voiced strong support for letting the embargo lapse, saying its end would contribute to the two-track policy pursued by supporters of the Syrian opposition: backing the rebels while pushing for a political settlement. The U.S. administration opposes continued Russian shipments of arms into Syria, including sophisticated S-300 air defence systems. The West has seen how the Assad regime uses those arms in enormous onslaughts against people who are unable to defend themselves.

The Syrian National Coalition, the main opposition group, urged the EU to promptly send ‘specialised weaponry to repel the fierce attacks waged against unarmed civilians’ by the Assad regime, its allies in Lebanon’s militant Hezbollah group and their Iranian backers. Washington and many of its European allies have been reluctant to send sophisticated weapons to Syrian rebels, fearing they could end up in the hands of radical Islamic groups such as the al-Qaeda affiliated Jabhat al-Nusra, a group which has emerged as the most effective and organised fighting force on the opposition’s side.

Israel has signalled it is prepared to strike Russian deliveries of air defence missiles systems to Syria, portraying them as a threat to the Jewish state and raising the spectre of a regional conflagration.

Russia, Mr Assad’s closest ally, has harshly criticised the decision by the EU to allow the arming of Syrian rebels, and says it undercuts international efforts to negotiate an end to the two year civil war. But Moscow has renewed its pledge to supply Assad’s regime with advanced missiles, which could transform an already brutal and bloody conflict into an East-West proxy fight. Russia insists it is carrying out deliveries of S-300 missile batteries under a contract signed with Syria several years ago.

Empowering Islamic extremists (through weaponry) to achieve questionable short-term goals will not serve the West’s long-term security or interests. And neither will shipments serve the interests of nearly 2 million Christians in Syria who fear they could suffer a similar fate as Iraqi Christians who were abused and expelled as radical Islamic forces gained influence and power. The welfare of these Christians is an important balancing act when deciding how to arm the Islamic militants. History must have taught by now that lessons should have been learnt from the past.

Although there are some well-intentioned reasons for wanting to intervene in Syria, there are far more well-documented reasons not to do so. In the aftermath of Afghanistan and Libya western weapons ended up in the hands of terrorists only later to be turned against their suppliers. The current irony is that a British neo-conservative government is actually lining up on the same side as al-Qaeda and Islamic extremists in Syria.

The lifting of the EU embargo does, though, come with conditions. European countries wishing to send weapons to Syria’s rebels may only send them to the moderate Syrian National Coalition and the affiliated Free Syrian Army, and they may only be used to protect civilians.

Whilst Western countries could conceivably provide rebels with small arms and ammunition, they’re unlikely to provide rebels with the type of arms they need most. The rebels will need weaponry like the portable shoulder-launched surface-to-air missiles (MANPADS) to counter Assad’s domination of Syrian airspace. Without anti-aircraft missiles or heavy armour piercing ammunition, it’s unlikely that the rebels will be unable to win the war.

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