A population-based study of the association between coronary artery bypass graft surgery (CABG) and cognitive decline: The Cache County Study

Constantine G. Lyketsos, Leslie Toone, Jo Ann Tschanz, Christopher Corcoran, Maria Norton, Peter Zandi, Ron Munger, John C.S. Breitner, Kathleen Welsh-Bohmer, James Anthony, Erin Bigler, James Burke, Robert C. Green, Liz Klien, Jeannette J. Townsend, Peter V. Rabins, Martin Steinberg, Truls Østbye, Carl Pieper, Brenda PlassmanDavid C. Steffens, Carol Leslie, Bonita W. Wyse, Michael Williams, Chiadi U. Onyike

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background: The relationship between coronary artery bypass graft (CABG) surgery and cognitive decline remains uncertain, in particular with regard to whether there is delayed cognitive decline associated with this procedure. Methods: This was a population-based cohort study involving participants in the Cache County Study of Memory Health and Aging. At baseline the study enrolled 5,092 persons age 65 and older and followed them up three years later and again four years after that. Individuals who reported having undergone CABG surgery at study baseline or had this surgery in between follow-up waves were compared to individuals who never reported having the surgery. The main outcome measure was the Modified Mini Mental State (3MS). Multilevel models were used to examine the relationship between CABG surgery and cognitive decline over time. Results: Study participants who had CABG surgery evidenced 0.95 points of greater decline relative to baseline on the 3MS at the first follow-up interview after CABG, and an average of 1.9 points of greater decline at the second follow-up interview, than those without CABG (t = -2.51, df = 2,316, p = 0.0121), after adjusting for several covariates, including number of vascular conditions. This decline was restricted to individuals who were more than five years past the procedure and was not evident in the early years after the surgery. Conclusions: CABG surgery is associated with accelerated cognitive decline more than five years after the procedure in a long-lived population. This decline is small and its clinical significance is uncertain. We could not find an association between CABG and decline in the first five post-operative years.

Original languageEnglish (US)
Pages (from-to)509-518
Number of pages10
JournalInternational journal of geriatric psychiatry
Issue number6
StatePublished - Jun 2006


  • CABG
  • Cognitive decline
  • Coronary artery bypass surgery
  • Dementia

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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