Anesthetics and its impact on the brain and Alzheimer's disease.

In summary, while the current clinical link between anesthesia andADis by nomeans conclusive in nature, together the preclinical and clinical studies provide enough evidence to warrant aggressive research on the incidence and progression of long-term cognitive impairment and dementia after exposure to anesthesia. Further comprehensive research is required to review the anesthesia protocols so as to limit the impact of anesthesia on patients with, or at risk of, AD. Research needs to prioritize adequately powered multi-centric prospective randomized controlled clinical trials aimed at comparing the effects of different anesthesia protocols, particularly volatile anesthetics, on the risk of AD. Large scale prospective studies that correlate cognitive function with CSF as well as imaging biomarkers of AD will go a long way toward elucidating the effect of anesthetics on the pathological processes and the consequent cognitive decline associated with AD. It is our sincere hope that future clinical studies will guide research efforts toward devising more specific and safer anesthetic interventions.