Special considerations: Alzheimer’s disease
Alzheimer’s disease (AD) is a progressive neurodegenerative disease and the most common cause of dementia worldwide. The characteristic symptoms of dementia involve problems in learning, memory, language, and problem-solving that arise from dying or damaged neurons in brain areas important for cognitive function. Due to its progressive nature, AD often presents in elderly patients. This chapter helps the anesthesiologist to better understand the potential for anesthetics and surgery to exacerbate symptoms of AD. It provides recommendations for anesthetic practices in patients with mild cognitive impairment and AD to avoid perioperative and postoperative complications. The presence of plaques and tangles can lead to the damage and death of neurons in many ways, including increased neuroinflammation and oxidative stress as well as disruptions of specific neurotransmitter systems. Several limits exist to identifying a true association between the risk of developing AD, anesthesia, and surgery.