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Digoxin and cognitive performance in patients with heart failure: a cohort, pharmacoepidemiological survey

Alice Laudisio1, Emanuele Marzetti, Francesco Pagano

  • 1Department of Gerontology, Geriatrics, and Physiatrics, Catholic University of Medicine, Rome, Italy. postalice@tiscali.it

Drugs & Aging
|February 18, 2009
PubMed

Insights

Digoxin may improve cognitive function in older adults with heart failure (HF). This study found a significant improvement in cognition for HF patients treated with digoxin compared to those without HF.

Area of Science:

  • Gerontology
  • Cardiology
  • Pharmacology

Background:

  • Cognitive dysfunction is common in heart failure (HF) patients, impacting disability and mortality.
  • Previous studies noted better cognitive performance in atrial fibrillation patients taking digoxin.
  • Endogenous digoxin affects neurotransmitters crucial for cognitive function.

Purpose of the Study:

  • To determine if digoxin treatment enhances cognition in heart failure patients.
  • To investigate the selective effect of digoxin on cognitive performance in HF.

Main Methods:

  • Pharmacoepidemiological cohort study of elderly hospitalized patients (age ≥ 65).
  • Utilized data from the GIFA study, including 1590 patients with verified HF.
  • Cognitive performance assessed using the Hodkinson Abbreviated Mental Test.

Main Results:

  • Cognition improved in 25% of HF patients on digoxin vs. 16% of non-digoxin users (p < 0.0001).
  • Digoxin use was associated with a 1.69 odds ratio for cognitive improvement in HF patients (95% CI 1.20, 2.38).
  • The positive association between digoxin and cognitive improvement was specific to patients with HF (p = 0.018).

Conclusions:

  • Digoxin treatment shows potential for selective cognitive improvement in elderly heart failure patients.
  • Findings suggest a specific benefit of digoxin for cognition in the context of heart failure.
Abstract

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