UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Factors associated with cognitive decline and delirium after transcatheter aortic valve implantation: Preliminary evidence

Ghezzi, Erica S; Psaltis, Peter J; Loetscher, Tobias; Davis, Daniel; Boord, Monique S; Greaves, Danielle; Montarello, Joseph; ... Keage, Hannah AD; + view all (2023) Factors associated with cognitive decline and delirium after transcatheter aortic valve implantation: Preliminary evidence. Delirium Communications 10.56392/001c.74542. Green open access

[thumbnail of Davis_Factors associated with cognitive decline and delirium after transcatheter aortic valve implantation_VoR.pdf]
Preview
Text
Davis_Factors associated with cognitive decline and delirium after transcatheter aortic valve implantation_VoR.pdf - Published Version

Download (702kB) | Preview

Abstract

Background: Transcatheter aortic valve implantation (TAVI) has become the standard for treating severe symptomatic aortic stenosis in those with prohibitive surgical risk. Cognitive complications, including delirium and cognitive decline are common following TAVI, yet an understanding of pre-procedural factors associated with these outcomes is lacking. This prospective observational study set out to identify geriatric pre-procedural factors associated with post-procedural delirium and cognitive decline in patients undergoing TAVI. / Methods: Cognitive outcomes of TAVI patients aged ≥60 years (N=32) were measured over one-year post-TAVI. Pre-procedural measures included frailty, gait, visual symptoms, voice pitch, dysphagia, blink rate, mood, and sleep. Primary outcomes were post-procedural delirium and cognitive decline. / Results: Delirium was present in 25% of patients over two days following TAVI and 26% experienced cognitive decline in the year post-TAVI. Daily physical activity was a protective factor against cognitive decline, and worse baseline visual memory was associated with delirium. While non-significant and with very large confidence intervals, moderate to large effect sizes were found for associations between slowed gait speed, pre-existing atrial fibrillation, and dysphagia for delirium, and slower gait speed, higher blink rate, pre-existing atrial fibrillation for cognitive decline. / Conclusion: Though underpowered, measures of considerable effect size were identified (although non-significant and with large variability). In larger studies, these novel geriatric factors could further be explored for predicting cognitive complications following TAVI. Improvement of risk prediction for cognitive decline and delirium following TAVI could assist with early identification of those at risk, informing clinical decision-making and allowing for targeted intervention to reduce post-procedural incidence of these complications.

Type: Article
Title: Factors associated with cognitive decline and delirium after transcatheter aortic valve implantation: Preliminary evidence
Open access status: An open access version is available from UCL Discovery
DOI: 10.56392/001c.74542
Publisher version: https://doi.org/10.56392/001c.74542
Language: English
Additional information: This is an Open Access article published under a Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/).
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
URI: https://discovery.ucl.ac.uk/id/eprint/10175332
Downloads since deposit
20Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item