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Clinical treatment reverses attentional deficits in congestive heart failure
1Department of Psychiatry and Behavioural Science, University of Western Australia, Perth, Australia. osvalm@cyllene.uwa.edu.au
Insights
Clinical treatment significantly improved attentional deficits and psychomotor speed in patients with congestive heart failure (CHF). Cognitive function in treated CHF patients became comparable to healthy controls.
Area of Science:
- Neurology
- Cardiology
- Psychology
Background:
- Congestive heart failure (CHF) is linked to cognitive impairments, especially in memory and attention.
- Attentional deficits are a significant concern for CHF patients.
Purpose of the Study:
- To determine if clinical treatment can reverse attentional deficits in patients with CHF.
- To assess the impact of medical intervention on cognitive function in CHF.
Main Methods:
- 50 patients with CHF (functional class IV) and 30 elderly controls underwent cognitive assessments (MMSE, CAMCOG, Digit Span, Digit-Symbol Substitution, Letter Cancellation, Trail Making A/B).
- Cognitive performance was re-evaluated after 6 weeks of clinical treatment.
- Correlation between cognitive scores and left ventricular ejection fraction was examined.
Main Results:
- CHF patients exhibited lower scores on CAMCOG, Digit Span, Digit Symbol, and Letter Cancellation tests compared to controls.
- CHF patients demonstrated slower performance on Trail Making A and B tests.
- Clinical treatment led to significant improvements in Digit Symbol and Letter Cancellation test scores.
- Post-treatment cognitive scores in CHF patients were similar to those of controls.
Conclusions:
- Congestive heart failure is associated with deficits in attention and psychomotor speed.
- Clinical treatment effectively improves these cognitive deficits in CHF patients.
- Cognitive function can be restored to levels comparable to controls with appropriate treatment.
Background:
Congestive heart failure (CHF) is associated with cognitive deficits, particularly of memory and attention. The present study aims to clarify whether clinical treatment can reverse the attentional deficits of patients with CHF.
Methods:
A convenience sample of 50 patients with CHF functional class IV and 30 elderly controls were recruited from a teaching hospital in Brazil. Participants received a clinical and cognitive examination that included the Mini-Mental State Examination (MMSE), Cambridge Cognitive Examination of the Elderly (CAMCOG), Digit Span, Digit-Symbol Substitution, and Letter Cancellation test. The cognitive performance of CHF patients was reassessed 6 weeks after the introduction of clinical treatment.
Results:
Twenty-seven CHF subjects had MMSE<24, compared to only 10 of the controls (p = 0.07). CHF patients also had lower CAMCOG scores (mean = 71.8) than controls (mean = 82.0; p < 0.01). Digit Span, Digit Symbol and Letter Cancellation scores were lower for patients with CHF than controls (p < 0.01). Similarly patients with CHF took longer to complete the Trail Making A (p = 0.07) and B (p < 0.01). CAMCOG scores and left ventricular ejection fraction were moderately correlated (rho = 0.4, p < 0.01). Nineteen patients were lost for follow-up (11 deceased). Clinical treatment was associated with significant improvement of cognitive scores, particularly on the Digit Symbol (p < 0.01) and Letter Cancellation Tests (p < 0.01). Digit Span, Digit Symbol, Letter Cancellation and Trail Making scores of treated CHF patients and controls were similar (p > 0.10).
Conclusions:
CHF is associated with deficits in attention and psychomotor speed. These deficits improve with clinical treatment.