title: The Relevance of Postoperative Cognitive Decline in Daily Living: Results of a 1-Year Follow-up.
abstract: OBJECTIVE
  Postoperative cognitive decline (POCD) has a perceivable influence on daily living and is noticed more often by close relatives than by patients themselves 3 months after aortic valve replacement. This study aimed to elucidate the longitudinal course of the subjective awareness of POCD.
  
  
  METHODS
  Follow-up of a prospective observational study.
  
  
  METHODS
  A single cardiothoracic center in Germany.
  
  
  METHODS
  The study included 108 patients scheduled for elective aortic valve replacement surgery and 85 close relatives of the patients.
  
  
  METHODS
  In addition to conducting a neuropsychologic examination, the authors previously interviewed 82 patients with a Cognitive Failure Questionnaire for self-assessment (s-CFQ), and 62 relatives with the Cognitive Failure Questionnaire for others (f-CFQ) before and 3 months after surgery. Up until 12 months after surgery, the authors continuously interviewed additional patients (baseline and 3 months after surgery), thereby enlarging the original sample, and included the entire group (108 patients, 85 relatives) for the 12-month follow-up.
  
  
  RESULTS
  The analysis showed that relatives (p = 0.026) and patients experienced patients' cognitive decline 3 months after surgery (p = 0.009). All changes still were observed in questions related to memory and attention. After 1 year, the s-CFQ no longer differed between baseline and postoperative assessment. Mean scores in the f-CFQ still were above baseline, barely missing statistical significance (p = 0.051). In patients with "change to worse" in the f-CFQ at 1-year follow-up, declining cognitive results in nonverbal learning (p = 0.021) could be observed 3 months postoperatively. Only a decrease in 3-month f-CFQ correlated with a decline in specific neuropsychologic tests 3 months after surgery.
  
  
  CONCLUSIONS
  Contrary to the authors' previous results, the impact of POCD on daily living functions also was recognized by the patients themselves. The long-term influence and the associations between subjective deficits and psychometric cognitive measures seemed to be assessed more reliably by close relatives.
authors.affiliation: Department of Neurology, Heart and Brain Research Group, University Hospital Giessen and Marburg, Giessen, Germany;; Department of Cardiac Surgery, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany;
authors.forename: Sabrina
authors.initials: S
authors.lastname: Kastaun
authors.affiliation: Department of Neurology, Heart and Brain Research Group, University Hospital Giessen and Marburg, Giessen, Germany;; Department of Neurology, Community Hospital Friedberg, Friedberg, Germany.
authors.forename: Tibo
authors.initials: T
authors.lastname: Gerriets
authors.affiliation: Department of Neurology, Heart and Brain Research Group, University Hospital Giessen and Marburg, Giessen, Germany;; Vitanas Geriatric Hospital MV, Berlin, Germany.
authors.forename: Niko P
authors.initials: NP
authors.lastname: Schwarz
authors.affiliation: Department of Neurology, Heart and Brain Research Group, University Hospital Giessen and Marburg, Giessen, Germany;; Department of Neurology, Community Hospital Friedberg, Friedberg, Germany.
authors.forename: Mesut
authors.initials: M
authors.lastname: Yeniguen
authors.affiliation: Department of Cardiac Surgery, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany;
authors.forename: Markus
authors.initials: M
authors.lastname: Schoenburg
authors.affiliation: Department of Neurology, Heart and Brain Research Group, University Hospital Giessen and Marburg, Giessen, Germany;
authors.forename: Christian
authors.initials: C
authors.lastname: Tanislav
authors.affiliation: Department of Neurology, Heart and Brain Research Group, University Hospital Giessen and Marburg, Giessen, Germany;; Department of Neurology, Community Hospital Friedberg, Friedberg, Germany. Electronic address: martin.juenemann@neuro.med.uni-giessen.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Juenemann
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery; D001288:Attention; D060825:Cognitive Dysfunction / Q000209:etiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000523:psychology*; D011446:Prospective Studies; D011795:Surveys and Questionnaires
keywords: 1-year follow-up; aortic valve replacement; assessment by others; postoperative cognitive deficits