For many years, coronary heart disease (CHD) has been the main cause of mortality in the population, while the number of patients operated on for CHD has increased steadily in recent years, including the proportion of elderly and senile patients. One of the most common neurological complications after the surgical treatment of CHD is the occurrence of cognitive impairments, the etiology and risk factors of which from a psychological point of view remain insufficiently studied. In this regard, an in-depth comparative study of the main clinical, psychosocial and emotional-personal characteristics of elderly patients with CHD with different dynamics (improvement and deterioration) of cognitive functioning after coronary bypass surgery was carried out. The division of patients into groups was implemented by using a mathematical expression of the dynamics of cognitive functions represented by two definitions of cognitive impairment (methods based on SD and 20%). The study showed that patients with the worst cognitive dynamics even at the preoperative stage differ in a number of clinical and psychosocial characteristics: not following the diet before hospitalization; lack of physical activity prior to hospitalization; a history of obesity of varying degrees; a large number of affected arteries; burdened with heredity for cardiovascular diseases in the male line. However, no reliable results of emotional-personality characteristics of elderly patients with different dynamics of cognitive functions were revealed.