Table 3:
Change in cognitive scores over time before and after post-enrollment exposure to general anesthesia (GA) with or without N2O and estimated difference in change in slope for GA without and with N2O
| Cognitive Score | GA without N2O* | GA with N2O* | GA without N2O – GA with N2O‡ | ||||
|---|---|---|---|---|---|---|---|
| Slope est.† | Change in slope est. (95% CI) | P | Change in slope est. (95% CI) | P | Difference in change in slope est. (95% CI) | P | |
| Global z-score | −0.075 | −0.062 (−0.085, −0.039) | <0.001 | −0.058 (−0.080, −0.035) | <0.001 | −0.004 (−0.035 to 0.026) | 0.783 |
| Domain specific z-score | |||||||
| Memory | −0.016 | −0.073 (−0.100, −0.045) | <0.001 | −0.064 (−0.089, −0.038) | <0.001 | −0.009 (−0.044 to 0.027) | 0.621 |
| Language | −0.080 | −0.002 (−0.024, 0.020) | 0.869 | −0.029 (−0.050, −0.008) | 0.007 | 0.027 (−0.001 to 0.055) | 0.057 |
| Visuospatial | −0.043 | −0.003 (−0.023, 0.017) | 0.756 | −0.005 (−0.025, 0.015) | 0.621 | 0.002 (−0.024 to 0.027) | 0.887 |
| Attention/executive | −0.096 | −0.052 (−0.080, −0.024) | <0.001 | −0.051 (−0.075, −0.027) | <0.001 | −0.001 (−0.036 to 0.034) | 0.953 |
Analyses presented are from adjusted linear mixed effects models. Six participants were excluded from the analyses because of missing covariates. After exclusions there were 1,813 participants included in the analysis (1,278 had not had a subsequent or new exposure prior to censoring, 280 had a subsequent or new exposure to GA without N2O, and 255 had a subsequent or new exposure to GA with N2O). All models are adjusted for prior 20-year exposure to GA without N2O, GA with N2O, age, sex, cognitive status at enrollment, education, marital status, Charlson comorbidity index, presence of APOE-ε4 genotype, ever-diagnosed alcohol problem, smoking status, mid-life diagnosis of diabetes, hypertension, and dyslipidemia, and history of atrial fibrillation, congestive heart failure, stroke, and coronary artery disease.
Slope estimate represents average annual change (slope) in z-score for participants prior to any post-enrollment exposure to surgery/GA.
Estimates, 95% confidence intervals, and P-values for the time-dependent change in slope following new exposure to GA without and with N2O based on a post-enrollment exposure;
P-value for comparison of change in slope estimates between GA without and with N2O.