I'm not a doctor and am not qualified to have any opinion about this,
but I'm curious to know how medical complications have been ruled
out.

If you do a Google search for "heart surgery" and "stroke" you'll find
lots of hits indicating that stroke is a common complication of heart
surgery.  For example from
http://www.scienceblog.com/community/older/1999/A/199900348.html

   "Stroke is one of the most devastating complications of heart
   surgery," says Charles W. Hogue Jr., M.D., associate
   professor of anesthesiology and chief of cardio-thoracic
   anesthesia at Washington University and Barnes-Jewish
   Hospital in St. Louis, Mo.

   Stroke incidence is as high as 5 percent in individuals
   undergoing bypass surgery, almost 9 percent in bypass
   patients age 75 or older and nearly 16 percent in patients
   with pre-existing disease involving blood flow in the brain
   or those undergoing heart valve surgery, according to Hogue.
   Bypass surgery involves rerouting blood flow around blocked
   blood vessels.

Alan

The answer is no telling at this point in time.  Our LO with dementia has
had major and minor surgery and always has major setbacks each time that
last from a day or so (dentist) to 6 months or longer (burst appendix
hospitalization). Minor wrist surgery took about 3 months to get back to
"normal" impairment level. The only answer is "time will tell".  good luck,
AW

How was stroke ruled out? MRI? if not, then the Drs are just guessing about
strokes or complications. Microstrokes after any medical procedure can
create profound mental deficits. An MRI on a patient with dementia involves
another round of strong anesthesia, so MRIs are often not done unless
absolutely necessary.

http://tinyurl.com/ykx7qe

Did he have a general anaesthetic? That is known to set back Az sufferers
some times very badly. I presume he had some sort of anesthesia to calm him
so even if  he wasnt totally unconscious it might have had a similar effect.

Hi Steve,

A couple of things occur to me. First off, "mild dementia" is not a
diagnosis. Its a description of symptoms. Do the doctors know what the
underlying cause of the dementia was. i.e. you get dementia FROM
disease processes such as Alzheimer's or Pick's, or from events like
strokes. Its important to know what the cause of his dementia was,
since it gives you a clue to what might be going on now.

Most people with Alzheimer's will undergo a delirium post anesthesia
that may last some time - my mother in law, for example, broke a hip in
early Alzheimer's and was profoundly confused post surgery. She had
been quite independent prior to the surgery, a little forgetful, but
doing very well at managing her life - afterwards, she was loopy ot the
point that the hospital sent a social worker to talk to us, suggesting
we were lying about her presurgery condition, and that we were deep in
denial.

She did come back mentally, but not quite all the way, and it took many
weeks, if not months. Who knows exactly how much of it was from the
anesthesia and how much from the stress of recovering from the hip
break.

However, having said that, what you are describing, three weeks after
the surgery, is certainly much more profound than what generally
happens to people with AD. It makes me wonder, as per others here, if
he didn't have dementia from multi-infarcts (an endless series of tiny
strokes). With multi-infarct, the person often has what they sometimes
call "TIAs" - transient ischemic attacks. If you look this up on the
net, you will find they suggest that TIAs are a sign a stroke may be
about to happen. However, more recent information suggests that every
time a person has a TIA, its from a little blockage, and even if you
don't get obvious stroke symptoms, damage is being done to the brain,
and it accumulates, and results in cognitive decline. TIAs are not
benign.

I would be insisting that some sort of brain scan be done to have a
look at what is going on - have they done this? This is NOT normal in
any way, even for a person with Alzheimer's.

I'm also confused by the doctor's use of the word sundowning. What
sundowning refers to is the phenomenon of getting worse in the
evenings. Many people with dementia do this - it has to do with the
fact that they are holding onto their facilties with their finger nails
- so they do best when they are well rested, calm, fed etc. - so early
in the day they may seem quite with it, and as the day unravells, they
seem to get worse. Not surprising that in the evening, when they are
tired, perhaps stressed by all the end of day activities, it gets dark
(many have vision and perception problems), etc. they seem to be more
confused and agitated. "Sundowning" has NOTHING to do with post
surgical confusion (which makes me think this doc knows nothing about
dementia). Have they had a neurologist in to see him?  

M.