Cognitive Function and General Anesthesia Exposure: A Cognitive Impairment Stage- Dependent Inverse Relationship

The relationship between general anesthesia (GA) exposure and cognition remains controversial. Using data from the Korea Dementia Research Center’s Trial Ready Registry, we examined the associations between a history of GA after the age of 50 and cognitive function, as measured using the Clinical Dementia Rating-Sum of Boxes (CDR-SB) and Global Deterioration Scale (GDS) scores, across the normal, mild cognitive impairment (MCI), and dementia groups. Ordinal logistic regression and subgroup analyses were performed on 688 participants (258 cognitively normal, 245 with MCI, and 185 with dementia). In the normal group, a history of GA was associated with higher CDR-SB (odds ratio [OR] = 2.20, P  = 0.031) and GDS scores (OR = 1.87, P  = 0.053). However, in the dementia group, GA was associated with lower CDR-SB (OR = 0.43, P  = 0.032) and GDS scores (OR = 0.40, P  = 0.022). Participants with a history of GA had higher CDR-SB and GDS scores in the normal group, but lower scores in the dementia group. No significant associations were observed in the MCI group. Thus, the relationship between GA exposure and cognitive function may differ depending on the stage of cognitive impairment, highlighting the need for stage-specific approaches in future research.