Change in behavioral functional capacity is associated with preexisting cognitive function rather than with cognitive decline in patients 1 year after cardiac surgery

Abstract

ObjectiveThe objective was to examine whether preexisting cognitive function rather than cognitive decline associated with intraoperative procedures may predict change in behavioral functional capacity in patients 1 year after cardiac surgery. MethodForty-five patients completed a cognitive evaluation, including the Trail Making Test part B (TMT-B) for attention and psychomotor speed, the Memory with 10-s interference for working memory, the Digit Span test for short-term memory and the Instrumental Activities of Daily Living (IADLs) questionnaire for behavioral functional capacity, before surgery and 1 year after cardiac surgery. ResultsSixteen patients (36%) exhibited cognitive decline after cardiac surgery. Preoperative scores on TMT-B significantly predicted change in behavioral functional capacity as measured by IADLs (beta=0.371, P<.05), whereas the postoperative cognitive decline and intraoperative variables were unrelated to residualized change scores in IADLs (all Ps>.08). ConclusionsPreexisting cognitive dysfunctions as assessed by TMT-B can be a marker of preoperative brain dysfunction, which, in turn, in addition to brain damage caused by cardiac surgery procedures, may further predispose patients to poor behavioral functional capacity and outcome 1 year after surgery. Impaired cognitive functions before surgery should be considered when evaluating the effects of cardiac surgery procedures on long-term behavioral functional status of patients.