title: Preexisting depressive symptoms are associated with long-term cognitive decline in patients after cardiac surgery.
abstract: OBJECTIVE
  To examine whether preoperative psychological dysfunctions rather than intraoperative factors may differentially predict short- and long-term postoperative cognitive decline (POCD) in patients after cardiac surgery.
  
  
  METHODS
  Forty-two patients completed a psychological evaluation, including the Trail Making Test Part A and B (TMT-A/B), the memory with 10/30-s interference, the phonemic verbal fluency and the Center for Epidemiological Studies of Depression (CES-D) scale for cognitive functions and depressive symptoms, respectively, before surgery, at discharge and at 18-month follow-up.
  
  
  RESULTS
  Ten (24%) and 11 (26%) patients showed POCD at discharge and at 18-month follow-up, respectively. The duration of cardiopulmonary bypass significantly predicted short-term POCD [odds ratio (OR)=1.04, P<.05], whereas preoperative psychological factors were unrelated to cognitive decline at discharge. Conversely, long-term cognitive decline after cardiac surgery was significantly predicted by preoperative scores in the CES-D (OR=1.26, P<.03) but not by intraoperative variables (all Ps >.23).
  
  
  CONCLUSIONS
  Our findings showed that preexisting depressive symptoms rather than perioperative risk factors are associated with cognitive decline 18 months after cardiac surgery. This study suggests that a preoperative psychological evaluation of depressive symptoms is essential to anticipate which patients are likely to show long-term cognitive decline after cardiac surgery.
authors.affiliation: Department of General Psychology, University of Padova, 35131 Padova, Italy. Electronic address: elisabetta.patron@studenti.unipd.it.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Patron
authors.forename: Simone
authors.initials: S
authors.lastname: Messerotti Benvenuti
authors.forename: Paolo
authors.initials: P
authors.lastname: Zanatta
authors.forename: Elvio
authors.initials: E
authors.lastname: Polesel
authors.forename: Daniela
authors.initials: D
authors.lastname: Palomba
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000523:psychology; D003072:Cognition Disorders / Q000209:etiology*; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013997:Time Factors
keywords: Cardiac surgery; Cognition disorders; Depression; Neuropsychology; Outcome assessment