Sex characteristics of cognitive functions assessed by the MMSE and MoCA scores in patients with coronary artery disease

Abstract

Aim. To study the sex characteristics of cognitive functions in a cohort of patients undergoing coronary artery bypass grafting (CABG) by comparing the results of Mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores.Material and methods. The prospective cohort study included 272 people, including 74 women aged 41 to 82 years, who were admitted to the Research Institute of Complex Issues of Cardiovascular Diseases for CABG surgery. All patients underwent clinical, laboratory, electrophysiological and ultrasound examinations. The Charlson comorbidity index (CCI) was calculated. Assessment of cognitive functions was carried out using the MMSE and MoCA scores. All types of statistical analysis were performed using the STATISTICA 10 program (StatSoft Inc., USA).Results. It was found that women scheduled for CABG have an older age and a higher CCI score compared to men (p=0,008). According to the MMSE, the likelihood of moderate and severe cognitive impairment in men compared with women was 1,36 times higher (odds ratio (OR), 1,35; 95% confidence interval (CI), 0,79-2,32, Z=1,11, p=0,27). The MoCA scores showed that half of the male (49%) and female (50%) participants had severe cognitive impairment. The likelihood of moderateand severe cognitive impairment in men compared with women was 1,33 times higher (OR, 1,33; 95% CI, 0,68-2,59, Z=0,841, p=0,40). According to subtests of the MoCA, men were better in naming (p=0,002), abstraction (p=0,005), and women outperformed men in verbal fluency (p=0,04). Regression analysis revealed that the most significant negative predictors for cognitive status as measured by the MMSE and MoCA scores for men and women were age and CCI.Conclusion. Women scheduled for CABG, having the worst clinical and demographic indicators, are comparable with men in cognitive status using the MMSE score. The MoCA score shows sex differences in naming, abstraction, and verbal fluency domains and revealed a higher percentage of severe cognitive disorders (up to 50%) compared to the MMSE score (7-9%). In male and female candidates for CABG, age and comorbidities are negatively associated with cognitive status.