Protecting the brain while healing hearts: The protective role of cognitive reserve in cardiac surgery

•What is the primary question addressed by this study?— we examined the impact of CR on POCD in patients undergoing cardiac surgery employing cardiopulmonary bypass and we conducted neuropsychological assessments of 101 patients before, and four months after, cardiopulmonary bypass surgery with the use of extracorporeal circulation.•What is the main finding of this study?—The finding must be limited to two sentences. Measures of executive functioning, learning, memory, visuospatial perception, anxiety, and depression were included in the assessment.•The prevalence and severity of POCD after cardiac surgery, and its effects on patients' functioning and quality of life, make it crucial to identify those who will require cognitive rehabilitation.•What is the meaning of the finding?—The meaning of the finding must be limited to one Our results suggest that CR can forecast neuropsychological outcomes of cardiac surgery, thus guiding the design of intervention programs to enhance patients’ overall post-surgical functional outcome. : One of the most significant complications following coronary artery bypass grafting (CABG) is postoperative cognitive decline (POCD), with intensity ranging widely from mild cognitive impairment to severe dementia and postoperative delirium. CABG patients frequently experience considerable postoperative cognitive dysfunction (POCD), including decline in attention, orientation, memory, judgment, and social functioning. Design: These negative effects may potentially be resolved by a protective factor, cognitive reserve (CR) that has been considered to function as a buffer against the consequences of neuropathology, aging, and/or trauma, describes the unique ways that individuals approach tasks, which may enable them to be more resilient than others. Patients with high CR develop stronger capacities to maintain their cognitive functions and to compensate for neurological loss and cognitive decline. Setting: We explored the frequency of POCD and CR in coronary artery disease patients undergoing CABG. We hypothesized that high levels of CR would protect against POCD after cardiac surgery. Participants: We assessed 101 patients before surgery, and four months after cardiopulmonary bypass surgery with the use of extracorporeal circulation. Measurements: Measures of cognitive functions, CR, anxiety, and depression were included in the assessment. Results: Age, educational attainment, occupation, functional score, and vocabulary measurements