This was followed by a statistically significant decline in mean scores for six of the eight domains during the 1- to 5-year time period. In determining the final baseline-to-5-year change, the group found that the combined initial Increase and the later decline in cognitive function resulted in no significant change between baseline and 5 years in most of the domains except visuoconstructlon and psychomotor speed, which both showed significant Inhibitors,research,lifescience,medical declines. Although few differences between baseline and 5 years postsurgery were observed, the results suggested a trend of late decline similar to that found in the Newman et al study.13 None of the covarlates measured, Including age, sex, race, medical

history, and operative and postoperative variables, was found to be statistically significant across many cognitive domains. Although this study had a large sample size and a comprehensive assessment of different cognitive functions, it also lacked a control group. In a Inhibitors,research,lifescience,medical later study, Selnes and colleagues20 used a group of nonsurgical coronary artery disease patients as a control, with a 1-year follow-up. buy PF-01367338 Interestingly, the study found no significant cognitive test differences between Inhibitors,research,lifescience,medical the CABG group and control subjects at 3 months and 1 year, indicating that perhaps certain levels of cognitive change are equally prevalent among all groups with risks for coronary artery disease, and that

surgical procedures might not have any effect on cognitive decline. In a follow-up study of the Inhibitors,research,lifescience,medical ISPOCD, 336 patients

from the original cohort were re-examined 1 to 2 years postoperatively. Forty-seven nonhospitalized volunteers from the control group were tested at the same Intervals. The authors15 reported that 1 to 2 years after surgery, 35 out of 336 patients (10.4%) had cognitive dysfunction. Of Inhibitors,research,lifescience,medical the 47 normal controls, (10.6%) fulfilled the criteria for cognitive dysfunction 1 to 2 years after Initial testing, ie, a similar Incidence of age-related cognitive impairment as among patients. Three patients (0.9%) had POCD at all three postoperative test sessions. Age, early POCD, and Infection within the first 3 postoperative months appeared to be significant risk factors for long-term cognitive dysfunction. Genetic factofs in POCD Tardiff and colleagues21 examined the role of the apolipoproteln E4 allele (ApoE4), a known genetic marker for Alzheimer’s disease, in below the development of POCD. This allele of the ApoE4 variant was associated with a decline in cognitive function at hospital discharge and at 6 weeks after surgery in four of nine cognitive measures. The authors argued that some Individuals have a decline in cognitive function owing to genetically determined factors. In contrast, Steed et al,22 using a larger sample of patients, found no association between the presence of the ApoE4 allele and cognitive decline after POCD.