title: Preexisting cognitive status is associated with reduced behavioral functional capacity in patients 3 months after cardiac surgery: an extension study.
abstract: OBJECTIVE
  To examine whether preexisting cognitive status rather than short- and middle-term postoperative cognitive decline (POCD) may differentially account for behavioral functional capacity 3 months after cardiac surgery.
  
  
  METHODS
  Seventy-nine patients completed a psychological evaluation, including the Trail Making Test Part B, the memory with 10-s interference, the phonemic fluency and the Instrumental Activities of Daily Living (IADLs) questionnaire for cognitive functions and behavioral functional capacity, respectively, before surgery, at discharge and at 3-month follow-up.
  
  
  RESULTS
  Thirty-one (39%) and 22 (28%) patients showed POCD at discharge and at 3-month follow-up, respectively. Preoperative cognitive status was significantly associated with change in behavioral functional capacity 3 months after surgery (Ps<.003), whereas short- and middle-term POCD and intraoperative risk factors were unrelated to residualized change in IADLs scores (all Ps>.095).
  
  
  CONCLUSIONS
  Preexisting cognitive deficit, especially working memory deficit, rather than short- and middle-term POCD related to intraoperative risk factors is associated with poor behavioral functional capacity 3 months after cardiac surgery. The present study therefore suggests that a preoperative cognitive evaluation is essential to anticipate which patients are likely to show a decline in behavioral functional capacity after cardiac surgery.
authors.affiliation: Department of General Psychology, University of Padova, 8-35131 Padova, Italy. Electronic address: simone.messerotti@unipd.it.
authors.forename: Simone
authors.initials: S
authors.lastname: Messerotti Benvenuti
authors.affiliation: Department of General Psychology, University of Padova, 8-35131 Padova, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Patron
authors.affiliation: Department of Anesthesia and Intensive Care, Treviso Regional Hospital, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Zanatta
authors.affiliation: Department of Cardiovascular Disease, Treviso Regional Hospital, Treviso, Italy.
authors.forename: Elvio
authors.initials: E
authors.lastname: Polesel
authors.affiliation: Department of General Psychology, University of Padova, 8-35131 Padova, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Palomba
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D003072:Cognition Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*
keywords: Behavioral functional capacity; Cardiac surgery; Cognitive impairment; Cognitive–behavioral assessment; Neuropsychology