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.
Keywords
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Article info
Publication history
Published online: September 23, 2016
Accepted:
September 9,
2016
Received:
September 6,
2016
Identification
Copyright
© 2016 Published by Elsevier B.V. on behalf of Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).
