Heart failure and cognitive impairment: challenges and opportunities
Related Experiment Videos
George A Heckman1, Christopher J Patterson, Catherine Demers
1Department of Medicine, McMaster University, Hamilton, Ontario, Canada. heck0@sympatico.ca
Insights
Heart failure (HF) is linked to impaired cognitive function (ICF) in older adults. Optimal HF therapy may help preserve or improve cognitive health, but more research is needed.
Area of Science:
- Cardiology
- Geriatrics
- Neurology
Background:
- Heart failure (HF) is a growing concern in aging populations, causing significant morbidity, mortality, and financial strain.
- Elderly individuals with HF are less likely to receive guideline-recommended treatments.
- Clinical trials often overlook outcomes crucial to the elderly, such as impaired cognitive function (ICF).
Purpose of the Study:
- To highlight the association between heart failure and impaired cognitive function in the elderly.
- To emphasize the clinical significance of ICF in HF patients.
- To encourage clinicians to screen for ICF and consider its impact on HF management.
Main Methods:
- The abstract reviews existing evidence on the relationship between HF and ICF.
- It discusses potential mechanisms linking HF to cognitive decline, including shared risk factors and hemodynamic changes.
- It examines the clinical manifestations and consequences of ICF in HF patients.
Main Results:
- Heart failure is associated with impaired cognitive function, presenting as delirium, mild cognitive impairment, or dementia.
- Shared risk factors and perfusion/rheological abnormalities in HF patients contribute to ICF.
- Evidence suggests standard HF therapies might partially reverse these cognitive abnormalities.
Conclusions:
- Impaired cognitive function has significant clinical consequences for heart failure patients.
- Clinicians should utilize screening tools to identify ICF in HF patients, particularly those at risk of nonadherence.
- Optimal HF therapy in the elderly may offer benefits for cognitive function, warranting further investigation.
Abstract:
As populations age, heart failure (HF) is becoming increasingly common, and in addition to a high burden of morbidity and mortality, HF has an enormous financial impact. Though disproportionately affected by HF, the elderly are less likely to receive recommended therapies, in part because clinical trials of HF therapy have ignored outcomes of importance to this population, including impaired cognitive function (ICF). HF is associated with ICF, manifested primarily as delirium in hospitalized patients, or as mild cognitive impairment or dementia in otherwise stable outpatients. This association is likely the result of shared risk factors, as well as perfusion and rheological abnormalities that occur in patients with HF. Evidence suggests that these abnormalities may be partially reversible with standard HF therapy. The clinical consequences of ICF in HF patients are significant. Clinicians should consider becoming familiar with screening instruments for ICF, including delirium and dementia, in order to identify patients at risk of nonadherence to HF therapy and related adverse consequences. Preliminary evidence suggests that optimal HF therapy in elderly patients may preserve or even improve cognitive function, though the impact on related outcomes remains to be determined.
Related Concept Videos
01:29Heart Failure II: Pathophysiology
01:26Heart Failure III: Clinical Manifestations
01:27Heart Failure I: Introduction
01:30Heart Failure V: Medical Management
01:30Heart Failure VII: Nursing Interventions
01:22Heart Failure VI: Adjunct Therapies