Key result
TAVR improves cognitive function scores at three months in elderly patients.
Why the study?
Preserving cognitive function and early detection of cognitive decline after TAVR in elderly patients are important, but research using full neuropsychological test batteries is limited.
Does transcatheter aortic valve replacement (TAVR) improve cognitive function in elderly patients at 3 months post-procedure?
Cohort (n=70)
No
Does transcatheter aortic valve replacement (TAVR) improve cognitive function in elderly patients at 3 months post-procedure?
Absolute Event Rate: -0.61% vs -0.73%
p-value: p=0.003
TAVR is associated with short-term improvements in overall cognitive function, particularly in language, memory, and frontal/executive domains, in elderly patients.
TAVR was associated with short-term cognitive gains in elderly patients; leaves open causality and requires randomized confirmation before practice change.
BACKGROUND: In elderly patients undergoing transcatheter aortic valve replacement (TAVR), preserving cognitive function and early detection of cognitive decline are important for maintaining quality of life after the procedure. While studies have reported cognitive changes after TAVR via short-form tests, research on the role of full neuropsychological test batteries remains limited. OBJECTIVES: To investigate short-term changes in cognitive function via a full neuropsychological test battery. METHODS: In this observational cohort study, 70 patients who underwent elective TAVR were assessed for cognitive performance via the Seoul Neuropsychological Screening Battery (SNSB) at baseline and 3 months post-TAVR. Mild cognitive impairment (MCI) was defined as a deterioration greater than 1.5 standard deviations below the normative mean. We also evaluated the effectiveness of the Mini-Mental State Examination (MMSE) in detecting MCI as assessed by the SNSB. RESULTS: The total SNSB z score significantly improved from baseline to 3 months post-TAVR (-0.73 [-1.58, -0.1] to -0.61 [-1.31, 0.1], P = 0.003), with notable enhancements in language, memory, and frontal/executive function. The incidence of MCI was 47.1% preoperatively and 45% at 3 months. Receiver operating characteristic curve (AUC) analysis revealed that the MMSE had good to excellent diagnostic ability for both multiple-domain and amnestic MCI compared to no MCI (AUC of 0.907 [95% CI, 0.790–0.971] and AUC of 0.796 [0.665–0.894], respectively) but it was ineffective in detecting single-domain MCI (AUC of 0.626 [0.486–0.751]). CONCLUSION: We found that patients who underwent TAVR had overall improvements in cognitive function at short-term follow-up. Our study highlights domain-specific cognitive changes and confirms the effectiveness of the MMSE in screening for clinically relevant cognitive impairment in elderly patients undergoing TAVR. CLINICAL TRIAL REGISTRATION: This study was registered with the Clinical Research Information Service ( https://cris.nih.go.kr/cris/search/detailSearch.do?search_lang=E&focus=reset_12&search_page=M&pageSize=10&page=undefined&seq=20661&status=5&seq_group=18840 and identifier: KCT0005970, principal investigator: Jeong-Jin Min, Date of registration: March 8, 2021).
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Oh et al. (2025) conducted a cohort in Severe symptomatic calcified native aortic valve stenosis (n=70). Transcatheter aortic valve replacement (TAVR) vs. Baseline (pre-TAVR) was evaluated on Change in total Seoul Neuropsychological Screening Battery (SNSB) z score from baseline to 3 months post-TAVR (p=0.003). In elderly patients undergoing TAVR, the total Seoul Neuropsychological Screening Battery z score significantly improved from baseline to 3 months post-procedure (median -0.73 to -0.61, p=0.003).
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