Lack of consent, major preoperative cognitive dysfunction (defined as CBB score <80), contraindication to DEX (untreated second-degree type 2 or third-degree heart block (pacemaker), cirrhosis, HR <50, grade IV left ventricle dysfunction, renal failure or on renal replacement therapy), unlikely to comply with study assessments (eg, no fixed address, cannot complete cognitive tests at the 3/6/12-month time points) and procedures requiring circulatory arrest.

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