Authors' objectives: To summarize current evidence on intermediate- and long-term cognitive outcomes after coronary and carotid revascularization, cardiac valve procedures, and ablation for atrial fibrillation in older adults, and their association with procedure-related stroke, transient ischemic attack (TIA), and other procedure and patient characteristics.

Authors' recommendations: Persistent cognitive impairment attributable to studied cardiovascular procedures in older adults appeared uncommon and may reflect pre-existing cognitive impairment. Specifically, CABG may have little intermediate to long-term cognitive effect in older adults, including numerous comparisons of different versions of CABG versus each other. Intermediate term cognitive effects may be similar between those who undergo surgical versus endovascular carotid revascularization. Results suggesting better cognition after minimal versus conventional extracorporeal bypass CABG are promising but need confirmation. Confidence in review findings should be tempered by substantial limitations in primary data quantity and quality. Results may not be generalizable to old-old patients, to women, or to patients with substantial baseline cognitive impairment.

Project Status: Completed

Year Published: 2015

URL for published report: http://www.cms.gov/Medicare/Coverage/DeterminationProcess/Downloads/id97ta.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)