Heart Failure Linked To Cognitive Impairment

Memory problems and other cognitive deficits may be an important factor to consider in planning medical care for patients with HF, according to the new study, led by Mary Jane Sauvé, D.N.Sc., R.N., of the University of California, Davis.

The researchers administered tests of cognitive (intellectual) function to 50 patients with HF and 50 people without HF, matched for age and estimated intelligence.  Most of the patients had mild to moderate HF. Overall, patients with HF scored lower than controls on 14 of 19 cognitive tests.  Forty-six percent of the HF patients were rated as having mild to severe cognitive impairment, compared to a 16 percent rate of mild impairment in controls.  Memory problems, especially short-term memory, were the most common type of cognitive deficit.

With adjustment for other factors, the risk of cognitive impairment was more than four times higher in the HF group.  The rate, types, and severity of cognitive impairment in this group of patients living with HF were similar to those seen in patients with end-stage HF awaiting heart transplantation.

Changes in cognitive function have long been recognized in patients with heart disease.  Although past reports have noticed an increased rate of cognitive impairment among people with HF, this has been assumed to reflect the age-related risk of cognitive decline.

These findings may have important implications for the care of patients with HF, Dr. Sauvé and colleagues believe.  For example, "Care instructions and medication or dietary changes need to be written and given verbally because of patient difficulties with information requiring attention, learning, and memory functions."

"This is a very important article dealing with a neglected area of research," commented Barry M. Massie, M.D., Editor-in-Chief of the Journal of Cardiac Failure.  "The authors have performed a well-designed study assessing heart failure patients for cognitive impairment, which was significant in a substantial proportion of patients.  Furthermore, it was closely related to the severity of symptoms or left ventricular dysfunction.  Clinicians should be aware of this problem, as it has the potential to interfere with optimal patient management."