A Population-Based Study of the Association between Coronary Artery Bypass Graft Surgery (CABG) and Cognitive Decline: the Cache County Study

Authors

Constantine G. Lyketsos, The Johns Hopkins UniversityFollow
Leslie Toone, Utah State University
JoAnn T. Tschanz, Utah State UniversityFollow
Chris D. Corcoran, Utah State UniversityFollow
Maria C. Norton, Utah State UniversityFollow
Peter Zandi, The Johns Hopkins University
Ronald G. Munger, Utah State UniversityFollow
John C. S. Breitner, University of Washington, DC
Kathleen Welsh-Bohmer, Duke University

Document Type

Article

Journal/Book Title/Conference

International Journal of Geriatric Psychiatry

Volume

21

Issue

6

Publisher

Wiley-Blackwell

Publication Date

2006

First Page

509

Last Page

518

Abstract

Background: The relationship between coronary artery bypass graft (CABG) surgery and cognitive decline remains uncertain, in particular with regard to whether there is delayed cognitive decline associated with this procedure. Methods: This was a population-based cohort study involving participants in the Cache County Study of Memory Health and Aging. At baseline the study enrolled 5,092 persons age 65 and older and followed them up three years later and again four years after that. Individuals who reported having undergone CABG surgery at study baseline or had this surgery in between follow-up waves were compared to individuals who never reported having the surgery. The main outcome measure was the Modified Mini Mental State (3MS). Multilevel models were used to examine the relationship between CABG surgery and cognitive decline over time. Results: Study participants who had CABG surgery evidenced 0.95 points of greater decline relative to baseline on the 3MS at the first follow-up interview after CABG, and an average of 1.9 points of greater decline at the second follow-up interview, than those without CABG (t = -2.51, df = 2,316, p = 0.0121), after adjusting for several covariates, including number of vascular conditions. This decline was restricted to individuals who were more than five years past the procedure and was not evident in the early years after the surgery. Conclusions: CABG surgery is associated with accelerated cognitive decline more than five years after the procedure in a long-lived population. This decline is small and its clinical significance is uncertain. We could not find an association between CABG and decline in the first five post-operative years.

Comments

Originally published by Wiley-Blackwell. Publisher's PDF available through remote link.

Recommended Citation

Lyketsos CG, Toone L, Tschanz J, Corcoran C, Norton M, Zandi P, Munger R, Breitner JCS, Welsh-Bohmer K and the Cache County Study Group. A population-based study of the association between coronary artery bypass graft surgery (CABG) and cognitive decline. International Journal of Geriatric Psychiatry,2006;21:509-518.