Preoperative daily step count and cognitive performance following cardiac surgery

Area of Science:

• Geriatric Medicine
• Cardiovascular Surgery
• Neuroscience

Background:

• Postoperative neurocognitive disorders affect 40-50% of patients after cardiac surgery.
• In older adults, exceeding 6500 daily steps is associated with cognitive benefits.

Purpose of the Study:

• To investigate if a preoperative daily step count of 6500 or more is associated with a reduced incidence of postoperative neurocognitive disorder.

Main Methods:

• An observational pilot study included patients aged 60+ undergoing elective cardiac surgery.
• Preoperative daily step counts were monitored, and patients were stratified into low (<6500) or high (≥6500) step groups.
• Cognitive function was assessed using the Montreal Cognitive Assessment at multiple time points.

Main Results:

• Patients in the high-step group had significantly lower rates of postoperative cognitive decline at discharge (6.7% vs 41.7%).
• High preoperative step counts were independently associated with lower odds of cognitive decline (OR, 0.104; P = .03).
• The high-step group demonstrated better cognitive scores at discharge.

Conclusions:

• Achieving 6500 or more steps daily before cardiac surgery is a significant predictor of better postoperative cognitive performance.
• Promoting higher physical activity levels, measured by step count, may be a viable strategy to mitigate neurocognitive deficits after surgery.