Will having an op wreck my memory?

DOES general anaesthetic affect your memory? In the past eight years I have had six general anaesthetics and my memory is not as good as it once was. Or is my memory loss down to old age? I am 72.

YOU and many others will be reassured to hear that general anaesthetics are not a proven cause of long-term memory loss.

Although there is much debate on the subject, there is no evidence that the drugs used in anaesthesia cause damage to the tissue of the brain.

Your concern is not unusual, however. It is a universal experience that after the age of about 50, people find their memory is not as sharp as it used to be. They tend to have particular trouble remembering names and recent events, such as what they had for lunch yesterday.

It’s a common issue that people see their GP about. Like you, they often voice anxieties about anaesthetic — after all, so many people in this age group will have had surgery or will be scheduled to have an operation — or they’re worried their memory has been affected by prescribed medication.

In the background, there is the fear that dementia is on the horizon. Yet these sorts of memory difficulties can be a normal part of the ageing process: brain scans of elderly people suggest the brain shrinks with age.

It is a matter of judgment and considerable expertise for doctors to differentiate between normal ageing and a condition known as mild cognitive impairment, an intermediate state between normal function and early dementia. The cornerstone of the evaluation is the medical consultation.

This face-to-face examination gives the patient’s GP a sense of the extent of the problem and enables them to make comparisons with others of the same age. It is one reason why it is so important to be seen by a doctor who knows you.

There are also screening tests available that GPs, neurologists and psychiatrists use, for instance a questionnaire called the minimental state examination. This includes questions about the date and time; it also tests the patient’s ability to recall a list of words, to do mental arithmetic and to spell a word backwards.

When the result of this test is abnormal it willbe followed by more detailed neuro-psychological testing. This usually involves longer tests under the care of a clinical psychologist, who will use questionnaires to determine which areas of cognitive function are affected. The patient may also undergo a CT or magnetic resonance brain imaging scan to check for cerebrovascular disease (where there are problems with blood supply to the brain — a possible cause of dementia) and other issues.

It would be unwise of me to venture an opinion about your own situation, but from what you have told me it is worth having a conversation with your GP.

I must stress again, however, that general anaesthetic is unlikely to have been the cause. Although there is much debate on the subject, there is no evidence that the drugs used in anaesthesia cause damage to the tissue of the brain. TWO years ago, I had a polyp removed from one nostril to enable me to smell and taste. But I have not been able to smell or taste anything since — other than my wife’s sugary tea.

You have what’s known as anosmia — the loss of the sense of smell which, in turn, affects taste. It is often caused by chronic rhinitis, or swelling in the nose.

Chronic rhinitis is usually associated with asthma and allergies. There’s also evidence that the bacterium S. aureus, which is found in the nasal lining of at least 30 per cent of people, can cause it.

Whatever the trigger, the mucus lining of the nose becomes inflamed, causing a runny or blocked nose, pain around the sinuses, and a reduced sense of smell.

As a result of the inflammation, some people develop polyps, which are swollen areas in the nasal lining. Larger ones will be removed through surgery, which usually improves breathing. But there’s often ongoing inflammation.

Polyps can also re-form, and it’s worth seeking a referral to your consultant. This may lead to further surgery or treatment in the form of anti-inflammatory corticosteroid nasal drops. Many patients regain their sense of smell on this regimen, but not all.