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Cognition, frailty, and functional outcomes of transcatheter aortic valve replacement

American Journal of Medicine Mar 24, 2020

Kapadia M, Shi SM, Afilalo J, et al. - In this single-center prospective cohort study involving 142 patients [mean age was 84.2 years] who were ≥ 70 years old, researchers explored the association of cognitive impairment and frailty with functional recovery after transcatheter aortic valve replacement. Participants in the study were patients who underwent transcatheter aortic valve replacement for aortic stenosis. At baseline and throughout 12 months, patients with moderate-to-severe frailty and cognitive impairment had the lowest functional status whereas patients with mild or no frailty and no cognitive impairment had the best functional status. At baseline, patients with cognitive impairment alone had a better functional status than those with moderate-to-severe frailty alone, but their functional status scores combined and remained similar during the follow-up. After transcatheter aortic valve replacement, preoperative cognitive function plays a vital role in functional recovery, irrespective of the baseline frailty status. Impaired cognition in the absence of frailty may increase the functional deterioration, whereas intact cognition may reduce the detrimental effects of frailty. Cognitive assessment should be conducted regularly before transcatheter aortic valve replacement.

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