Neurocognitive test battery Postoperative cognitive decline in the elderly following cardiac surgery Kalliopi Megari1,2, Mary H. Kosmidis¹ & Kyriakos Anastasiadis² 1Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece 2Department of Thoracic and Cardiovascular Surgery, Aristotle University of Thessaloniki, AHEPA Hospital, Greece  Introduction Postoperative cognitive deficits are significant complications after cardiac surgery, particularly in elderly patients. Various methods of extracorporeal circulation (ECC) during surgery affect postoperative cognitive recovery differentially, favoring the minimal ECC (MECC), with significantly lower risk of cognitive decline, over the conventional (CECC) system (Anastasiadis et al., 2011). Aim of the study: We examined the relative benefit of the MECC, as compared with the CECC, system in a group of elderly (61-80 years old) and middle-aged (40-60 years old) patients undergoing coronary artery bypass grafting (CABG) both immediately post-operatively and at 3-month follow-up. Hypothesis : Patients with MECC from both age groups will exhibit less postoperative cognitive dysfunction than those with CECC. Method Results Participants: 60 patients MECC n=29 (middle-aged=12, elderly=17) CECC n=31 (middle-aged=12, elderly=19) Neurocognitive evaluation Tested before surgery, prior to discharge (1 week) and at 3-month follow-up with alternative forms of tests Neurocognitive test battery All patients elderly patients from both ECC systems showed cognitive decline more often than middle-aged patients 3 months after surgery p=.023 MECC patients Test variables Digit Span-Forwards Functions Short-term retention Digit Span-Backwards Verbal working memory Stroop Color- Word Test Executive functions Symbol-Digit Modalities Test Complex scanning, visual tracking Judgment of Line Orientation Test Visual-spatial perception Fuld Object–Memory Evaluation Test, Storage Short-term memory, learning Fuld Object–Memory Evaluation Test, LT Retrieval Long-term memory, retrieval Geriatric Depression Scale Depression Positive & Negative Affect Schedule Positive & negative mood State-Trait Anxiety Inventory- Short Form Anxiety elderly patients showed impairment immediately after surgery more frequently than middle-aged patients, but there was no age related difference after 3 months. p=.032 p=.062 CECC patients both age groups demonstrated cognitive decline immediately and 3 months after surgery to the same extent. Cognitive decline A decrease of 1 SD in post-surgery relative to pre-surgery performance on one or more neuropsychological tests p=.309 p=.319 Conclusions Our findings suggest that the use of MECC systems, while beneficial in reducing postoperative neurocognitive decline for all ages, is more so for elderly patients at 3 month post-surgery follow-up. This may be of particular importance since elderly patients are more susceptible to developing postoperative cognitive decline. Cognitive stability plays a significant role in the life of elderly patients, especially after heart surgery. Reference: Anastasiadis K, Argiriadou H, Kosmidis MΗ, Megari K, Thomaidou E, Antonitsis P, Karapanagiotidis G , Aretouli Ε & Papakonstantinou C. (2011). Neuro-cognitive outcome after coronary artery bypass surgery with minimal versus conventional extracorporeal circulation: A randomized pilot study. Heart, 97(13), 1082-1088. 5th International Congress on Brain & Behavior and 18th Thessaloniki Conference of the South-East European Society for Neurology and Psychiatry, 3-6 November 2011, Thessaloniki, Greece E-mail : kmegari@psy.auth.gr