There is a need to optimize long-term cognitive and functional outcomes in the aging population during and after cardiothorasic surgery, including the development of simple, objective tools to enable risk stratification for vulnerability to neurocognitive deficit. First, cardiothoracic surgical trials and clinical studies should be more "age-representative" and reflect the increasing proportion of the aging population. Second, we need to improve the applicability of cardiothoracic surgery trials to the aged (e.g., comparisons of treatments for valvular heart disease). Third, concern for cognitive decline following cardiothoracic surgery is of particular concern in older individuals.
Tools for studying this population are needed.