Twelve-month follow-up effects of cognitive training after heart valve surgery on cognitive functions and health-related quality of life: a randomised clinical trial

Objectives: Postoperative cognitive decline (POCD) or decreased health-related quality of life (HQL) have been reported after cardiac surgery. A previous investigation showed beneficial effects of postoperative cognitive training on POCD and HQL 3 months after heart surgery. Here, we present the 12-month follow-up results.

Methods: This bicentric, 1:1 randomised and treatment-as-usual controlled trial included elderly patients scheduled for elective heart valve surgery. The training consisted of paper-and-pencil-based exercises practising multiple cognitive functions for 36 min/day 6 days/week over a period of 3 weeks. Neuropsychological tests and questionnaires assessing HQL (36-Item Short Form Health Survey (SF-36)) and cognitive failures in daily living (Cognitive Failures Questionnaire) were performed presurgery and 12 months after training.

Results: Twelve months post training, the training group (n=30) showed improvements in HQL compared with the control group (n=28), especially in role limitations due to physical health (U=-2.447, p=0.015, η²=0.109), role limitations due to emotional problems (U=-2.245, p=0.025, η²=0.092), pain (U=-1.979, p=0.049, η²=0.068), average of all SF-36 factors (U=-3.237, p<0.001, η²=0.181), health change from the past year to the present time (U=-2.091, p=0.037, η²=0.075), physical component summary (U=-2.803, p=0.005, η²=0.138), and mental component summary (U=-2.350, p=0.018, η²=0.095). Furthermore, the training group (n=19) showed an improvement compared with the control group (n=27) in visual recognition memory (U=-2.137, p=0.034, η²=0.099). POCD frequency was 22% (n=6) in the control group and 11% (n=2) in the training group (χ²(1) =1.06, p=0.440; OR=2.43, 95% CI 0.43 to 13.61).

Conclusion: In conclusion, postoperative cognitive training shows enhancing effects on HQL in cardiac surgery patients after 12 months.