Best anasthetic for older patients to avoid contributihng to any Alzheimers or other dementia?

Minimizing anesthesia is always a good idea. This is why I perform all my facial aesthetic procedures under local anesthesia with moderate sedation. This includes facelifts, eyelid surgery, brow lifts, etc. If the surgeon is experienced in giving the local anesthesia by first blocking some of the sensory nerves, the discomfort is minimal. This is why I only use medicine for relieving the pain of injection and a sedative to remove the patient's anxiety. The surgeons who are not comfortable with local anesthesia techniques will tell you that you could not have the proper operation without general anesthesia or heavy sedation. This is not true.

There is no definitive evidence that general anesthesia will cause worsening dementia or accelerate Alzheimers. Having said that, there are plenty of stories of patients who said they have "brain fog" after general anesthesia. I have performed many facelifts, fat transfers, and lip lifts under pure local anesthesia and have also combined them with IV sedation with Versed/Propofol, etc. These options may be a consideration when undergoing this procedure and it is best to have a good conversation with your surgeon and anesthesiologist.

So there is really alot of ongoing research about the potential connection between neurocognitive decline and general anesthesia. Most associate it with the use of isoflurane and sevoflurane but there really is not any definitive evidence one way or the other.

If you are particularily risk adverse in this arena, you can consider local anesthesia which is possible for fat transfer and lip lift and neck lift and a little difficult with facelift but possible. you can also have pure propofol with iv sedation or an LMA during anesthesia to avoid inhalation agents. Keep in mind that there is not a conclusive study to definitively pick one method of anesthesia as safer than others for neurocognitive decline. Best of luck!!