Cognitive Outcomes of Cardiovascular Surgical Procedures in the Old: An Important but Neglected Area

Hannah A D Keage, Ashleigh Smith, Tobias Loetscher, Peter Psaltis

Research output: Contribution to journalEditorial

3 Citations (Scopus)

Abstract

Older individuals can now undergo invasive cardiovascular procedures without serious concern about mortality, and the numbers and proportions of the over 65s and 85s doing so in Australia has been increasing over the last 20 years. There is overwhelming evidence linking cardiovascular conditions to late-life (65 years and over) cognitive impairment and dementia including Alzheimer's Disease, primarily due to impaired cerebrovascularisation and cascading neuropathological processes. Somewhat paradoxically, these cardiovascular interventions, carried out with the primary aim of revascularisation, are not usually associated with short- or long-term improvements in cognitive function in older adults. We discuss factors associated with cognitive outcomes post-cardiovascular surgeries in patients over 65 years of age. There are many opportunities for future research: we know almost nothing about cognitive outcomes following invasive cardiac procedures in the oldest old (85 years and over) nor how to predict the cognitive/delirium outcome using pre-surgical data, and lastly, intervention opportunities exist both pre and postoperatively that have not been tested. As our population ages with increased cardiovascular burden and rates of cardiovascular interventions and surgeries, it is critical that we understand the cognitive consequences of these procedures, who is at greatest risk, and ways to optimise cognition.

Original languageEnglish
Pages (from-to)1148-1153
Number of pages6
JournalHeart Lung and Circulation
Volume25
Issue number12
DOIs
Publication statusPublished - 1 Dec 2016

Keywords

  • Cardiovascular surgery
  • Cognition
  • Dementia
  • Elderly
  • Old

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this