The impact of depression on non-pharmacological cognitive interventions in patients undergoing cardiac surgery: A systematic review


  • Malissa A. Mulkey, PhD, APRN, CCNS, CCRN, CNRN University of South Carolina
  • Anne Sorrell, MA East Carolina University
  • Anya Savransky, MS East Carolina University
  • D. Erik Everhart, PhD, ABPP East Carolina University
  • Kelly L. Wierenga, PhD, RN Indiana University-Purdue University



cardiac surgery, cognition, depression, interventions, review,



Depression is associated with cardiac-related events and cognitive dysfunction contributing to poorer health outcomes and quality of life. Specifically, after cardiac surgery, broad cognitive domains are negatively affected. To address cognitive dysfunction following cardiac surgery, researchers have tested non-pharmacological interventions with varied success. Depression is associated with worse cardiac and cognitive health outcomes yet depression’s potential contribution to interventions mitigating cognitive dysfunction following cardiac surgery is poorly understood.  



This review aims to examine the impact of depression on the effectiveness of non-pharmacological interventions designed to minimize cognitive dysfunction associated with cardiac surgery. 



A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Peer-reviewed articles between January 2011 to February 2022 obtained from PubMed, MEDLINE, EMBASE, Psych INFO, CINAHL, and the Web of Science databases were screened for inclusion based on predetermined criteria. Each article was screened, and data was abstracted by two authors. 



Of 8128 articles screened, 442 were assessed for eligibility and 4 met inclusion criteria. Three of the studies did not report associated depression scale scores. The other study reported depression symptoms as mild to severe. 



These findings suggest limited information exists regarding the relationship between depression and cognitive function among cardiac surgery patients who undergo non-pharmacologic interventions. Future studies should carefully examine symptoms of depression in relation to cognitive impairment post-cardiac surgery; such studies may further guide clinical interventions. 





How to Cite

Mulkey, M., Sorrell, A., Savransky, A., Everhart, D. E., & Wierenga, K. (2023). The impact of depression on non-pharmacological cognitive interventions in patients undergoing cardiac surgery: A systematic review. International Journal of Critical Care, 17(3), 69–87.

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