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Prognostic importance of cognitive impairment in chronic heart failure patients: does specialist management make a

Skye N McLennan1, Sue A Pearson, Janette Cameron

  • 1University of South Australia, Division of Health Science, Australia.

European Journal of Heart Failure
|March 1, 2006
PubMed

Insights

Mild cognitive impairment significantly increases mortality risk in chronic heart failure (CHF) patients. This prognostic importance persists even with a CHF management program (CHF-MP).

Area of Science:

  • Cardiology
  • Neurology
  • Gerontology

Background:

  • Cognitive impairment is a prevalent comorbidity in patients with chronic heart failure (CHF).
  • The prognostic implications of cognitive impairment in CHF patients require further elucidation.

Purpose of the Study:

  • To assess the prognostic significance of cognitive impairment in CHF patients enrolled in a randomized CHF management program (CHF-MP).

Main Methods:

  • A randomized controlled trial comparing a CHF-MP (n=100) to usual care (n=100).
  • Baseline cognitive function was evaluated using the Mini Mental Status Examination (MMSE).
  • Five-year all-cause mortality and death-or-readmission rates were compared between patients with and without cognitive impairment (MMSE 19-26 vs. >26).

Main Results:

  • 13.5% of CHF patients exhibited cognitive impairment (MMSE 19-26).
  • Cognitively impaired patients had a significantly higher adjusted risk of all-cause mortality (RR 2.19, P<0.001) and unplanned hospitalization (RR 1.44, P=0.019).
  • While not significant overall, the CHF-MP mitigated the increased risk of death-or-readmission for cognitively impaired patients compared to usual care. However, within the CHF-MP, cognitively impaired patients still showed a significantly higher adjusted risk of death (RR 2.33, P=0.027).

Conclusions:

  • Mild cognitive impairment (MMSE 19-26) is a significant prognostic indicator in CHF patients.
  • The prognostic impact of cognitive impairment persists even when patients receive a CHF management program.
  • Further research may explore tailored interventions for cognitively impaired CHF patients.
Abstract

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