Expert: Ronald Levy, M.D. - 1/30/2007

Question
Thank you for your response. Can you expand a bit on the point you made about the memory loss and the long convalescence? How are they possibly related?
-------------------------------------------
The text above is a follow-up to ...

-----Question-----
My mother is 88 years old and last month had emergency surgery for an incarcerated hernia. She just returned home, after 5 days in the hospital and almost 4 weeks in a convalescent facility. She seems to have noticeable memory loss since the surgery. Although her short term memory was not great before the surgery, it seems that her memory has deteriorated more since the surgery. She is aware of this and is quite upset about it. She lives alone, and is still able to manage her own affairs to a greta extent. However, she does not exhibit the ability to understand or recall details when the rehab center spoke to her about after care help, and she definitely repeats herself within the same conversation. My two brothers and I all live in NY and my mother is in Florida, so this makes it difficult to help her as much as we would like.

I've read that anesthesia can have an impact on memory in elderly patients. My mother is also taking Vytorin, Glucophage, and Monopril.

Can we expect any recovery of memory function? How likely is it that the anesthesia is the cause of the recent deterioration?   

Thank you for your help.
-----Answer-----
Anesthesia is not a cause of long term memory loss. We give certain drugs that can give you amnesia for recent events (particularly around the time of surgery) but these should not affect earlier (or later) memories. The anesthesia may make her forgetful for several days post surgery but the like cause of your mother's memory problems is probably related to her long convalescence. Whether there will be a return to pre-surgery days is unknown. The best thing you can do is supportive by keeping her mind active. While there are no guarantees, it certainly can't hurt.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston

Answer
I'll preface this by saying that all I'm saying is speculation (having not examined your mother).

It is a combination of poor nutritional status, age, immobility and surroundings. For example, elderly patients in an ICU for a long time often develop psychoses (agitated, hallucinations, etc) from the constant lights, beeping sounds and sleep deprivation. This happen to a lesser extent on the hospital ward. I remember being an inpatient for a minor problem and every 4 hours a nurse would come to my room to take my vital signs (where there was no reason to expect that they changed from 4 hours previously!). When you are young, these problems quickly disappear, but as you age, they tend to persist longer. Nutrition is obvious as the brain also needs adequate nutrition to function well and you never eat as well in a hospital as at home.

Hope this helps,

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston