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Cognitive impairment and medication adherence in outpatients with heart failure

Lee Ann Hawkins1, Shirley Kilian, Anthony Firek

  • 1VA Loma Linda Healthcare System, Loma Linda, California, USA. LeeAnn.Hawkins@va.gov

Heart & Lung : the Journal of Critical Care
|July 13, 2012
PubMed

Insights

Cognitive impairment (CI) affects over half of outpatient veterans with heart failure (HF), leading to poorer medication adherence (MA). Routine screening for CI in HF patients is recommended.

Area of Science:

  • Cardiology
  • Neurology
  • Geriatrics

Background:

  • Heart failure (HF) management requires strict adherence to therapy.
  • Cognitive impairment (CI) can negatively impact treatment adherence.
  • Little is known about CI prevalence and its effects in veteran populations with HF.

Purpose of the Study:

  • To determine the prevalence and severity of CI in outpatient veterans with HF.
  • To identify cognitive domains affected by CI in this population.
  • To examine factors associated with CI and its relationship with medication adherence (MA).

Main Methods:

  • 251 veteran outpatients with HF were enrolled.
  • Cognitive impairment (CI) was screened for, with further neuropsychological testing for affected individuals.
  • Medication adherence (MA) was assessed using pill counts.

Main Results:

  • Unrecognized CI was prevalent in 58% of subjects.
  • Verbal learning, immediate memory, and delayed verbal memory were the most affected cognitive domains.
  • CI was significantly associated with poorer MA, with age, race, depression, alcohol use, and non-participation in pill counts linked to CI.

Conclusions:

  • A high prevalence of unrecognized CI exists in veterans with HF.
  • CI is significantly associated with poorer medication adherence (MA).
  • Routine screening for CI in patients with HF is proposed.
Abstract

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