title: Pre-Operative Cognitive Functioning and Inflammatory and Neuroendocrine Responses to Cardiac Surgery.
abstract: Cognitive functioning is linked to cardiac mortality and morbidity, but the mechanisms underlying this relationship are unclear.
  
  
  
  To examine the relationship between pre-operative cognitive functioning and post-operative inflammatory and neuroendocrine responses in patients undergoing coronary artery bypass graft (CABG) surgery.
  
  
  
  One-hundred ninety-three outpatients were screened to assess their cognitive function using the Montreal Cognitive Assessment (MoCA) on average 30 days prior to CABG surgery and provided blood samples for the measurement of interleukin (IL)-6 and C-reactive protein (CRP) and saliva samples for the measurement of diurnal cortisol. Participants were followed-up 4-8 days following surgery for the repeat measurement of IL-6 and CRP and 60 days after surgery for the measurement of diurnal salivary cortisol.
  
  
  
  Patients with low cognitive function (MoCA < 26) prior to surgery reached higher IL-6 concentrations in the days after surgery (β = -0.212, p = 0.021) and had greater cortisol output across the day 2 months after surgery (β = -0.179, p = 0.044).
  
  
  
  Low cognitive functioning is associated with a more negative pattern of biological response to surgery, indicative of poorer physical recovery. These pathways may contribute to the links between cognitive function and cardiovascular pathology.
authors: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK. lydia.poole.09@ucl.ac.uk.
authors: Lydia
authors: L
authors: Poole
authors: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
authors: Amy
authors: A
authors: Ronaldson
authors: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
authors: Tara
authors: T
authors: Kidd
authors: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
authors: Elizabeth
authors: E
authors: Leigh
authors: Department of Cardiac Surgery, St George's Hospital, University of London, Blackshaw Road, London, SW17 0QT, UK.
authors: Marjan
authors: M
authors: Jahangiri
authors: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
authors: Andrew
authors: A
authors: Steptoe
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D003071:Cognition; D001026:Coronary Artery Bypass / Q000523:psychology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D011184:Postoperative Period; D057234:Preoperative Period; D012463:Saliva / Q000378:metabolism
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6; D002097:C-Reactive Protein; D006854:Hydrocortisone
keywords: Cognition; Coronary artery bypass graft surgery; Cortisol; Inflammation