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Published on: April 23, 2021

Cognitive impairment: a key feature of congestive heart failure in the elderly

Luigi Trojano1, Raffaele Antonelli Incalzi, Domenico Acanfora

  • 1Dept. of Psychology, 2nd University of Naples, Caserta, Italy. luigi.trojano@unina2.it

Journal of Neurology
|December 16, 2003
PubMed

Insights

Congestive heart failure (CHF) significantly impairs cognitive function, especially in severe cases. Cognitive deficits are linked to CHF severity, depression, and hypertension, affecting over half of severe CHF patients.

Area of Science:

  • Cardiology
  • Neurology
  • Psychiatry

Background:

  • Congestive heart failure (CHF) is suspected to cause cognitive dysfunction, but direct evidence is limited.
  • Few studies have assessed cognitive performance specifically in CHF patients.

Purpose of the Study:

  • To compare cognitive patterns in patients with CHF versus those with cardiovascular disease without CHF.
  • To identify factors associated with cognitive impairment in CHF patients.

Main Methods:

  • A multicenter observational case-control study involving 149 moderate CHF (NYHA class II), 159 severe CHF (NYHA class III-IV), and 207 no-CHF patients.
  • Multidimensional assessment and neuropsychological tests evaluating attention, visual-spatial intelligence, verbal attainment, and memory.
  • Multivariate analysis and logistic regression to compare cognitive performance and identify correlates of impairment.

Main Results:

  • Severe CHF patients performed significantly worse on attention and verbal learning tests compared to no-CHF patients.
  • Prevalence of significant cognitive impairment was 57.9% in severe CHF, 43% in moderate CHF, and 34.3% in no-CHF groups.
  • Independent correlates of cognitive impairment included severe CHF, depression, and hypertension.

Conclusions:

  • Cognitive impairment is prevalent in CHF patients and is associated with CHF severity.
  • Depression and hypertension are independent risk factors for cognitive dysfunction in CHF.
  • Cognitive dysfunction is also present in a notable proportion of cardiovascular disease patients without CHF.

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