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Depression predicts cognitive and functional decline one month after coronary artery bypass graft surgery (Neuropsychiatric Outcomes After Heart Surgery study)
Author(s) -
Oldham Mark A.,
Lin IHsin,
Hawkins Keith A.,
Li FangYong,
Yuh David D.,
Lee Hochang B.
Publication year - 2021
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.5443
Subject(s) - cognitive decline , depression (economics) , coronary artery bypass surgery , medicine , geriatric depression scale , clinical dementia rating , repeatable battery for the assessment of neuropsychological status , prospective cohort study , delirium , verbal fluency test , dementia , cognition , psychology , cardiology , neuropsychology , psychiatry , artery , depressive symptoms , disease , economics , macroeconomics
Background Prior research on cognitive and functional outcomes after coronary artery bypass graft (CABG) surgery has largely explored these two domains in isolation. In this study, we assess baseline depression and cognition as risk factors for decline in the Clinical Dementia Rating Sum‐of‐Boxes (CDR‐SB) 1 month post‐CABG surgery, which a combined measure of cognition and function. Design The Neuropsychiatric Outcomes After Heart Surgery study is a prospective observational cohort study. Setting A tertiary care, academic center. Participants Of a total study sample of 148 patients undergoing CABG surgery, 124 (83.8%) completed 1‐month follow‐up assessment. Mean age was 66.3, 32 (25.8%) female and 112 (90.3%) White. Measurements Cognition, function, and depression were assessed on semi‐structured clinical interviews. Cognitive and functional status were defined using CDR‐SB; mild or major depression was defined by the Hamilton Depression Rating Scale. Additionally, neuropsychological battery was performed at baseline. Results CDR‐SB decline occurred in 18 (14.5%) subjects. Older age, depression, baseline CDR‐SB, and postoperative delirium were associated with 1‐month decline on univariate analysis. Older age (OR 1.1 [1.0–1.2]) and depression (OR 6.2 [1.1–35.0]) remained significant on multivariate regression. In separate models, baseline performance on visual Wechsler memory scale (delayed), Hopkins verbal learning test (immediate and delayed), controlled oral word fluency test, and Trails B predicted CDR‐SB decline. Conclusion Roughly one in seven patients experienced CDR‐SB decline 1 month after CABG surgery. Also, preoperative depression deserves recognition for being a predictor of CDR‐SB decline one month post‐CABG.