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Cognitive Impairment and Heart Failure: Systematic Review and Meta-Analysis.
Jane A Cannon1, Peter Moffitt2, Ana Cristina Perez-Moreno1
1Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK.
Journal of Cardiac Failure
|April 24, 2017
Summary
Heart failure patients frequently experience cognitive impairment, with a 43% prevalence. This highlights the need for integrated care planning and further research into the causes of cognitive decline in heart failure.
Area of Science:
- Cardiology
- Neurology
- Gerontology
Background:
- Cognitive impairment and dementia are linked to cardiovascular diseases like hypertension and atrial fibrillation.
- Heart failure (HF) is a significant cardiovascular condition with potential neurological implications.
- Existing research suggests an association between HF and cognitive decline, but comprehensive data is limited.
Purpose of the Study:
- To systematically review and synthesize existing literature on the association between heart failure and cognitive impairment/dementia.
- To provide estimates for the prevalence, incidence, and relative risk of cognitive impairment in individuals with heart failure.
- To identify gaps in knowledge regarding the pathophysiology linking heart failure and cognitive dysfunction.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (MEDLINE, EMBASE, CINAHL, PsychINFO, Web of Science, CENTRAL) up to May 2015.
- Studies examining cognitive impairment or dementia in heart failure patients were selected by two independent reviewers.
- Meta-analysis was performed where data permitted, using random-effects models to pool results.
Main Results:
- Out of 18,000 titles, 37 studies (8,411 participants) were included. Data from 4 prospective cohorts indicated greater cognitive decline in HF patients over time.
- Case-control studies (1,414 participants) revealed an odds ratio of 1.67 for cognitive impairment in heart failure patients.
- Prevalence of cognitive impairment in heart failure cohorts (4,176 participants) was estimated at 43% (95% CI: 30-55%).
Conclusions:
- A significant portion of patients with heart failure experience co-occurring cognitive problems.
- These findings have important implications for the planning of treatment strategies and healthcare services for HF patients.
- Further research is required to elucidate the underlying pathophysiology and establish causality between heart failure and cognitive impairment.
Keywords:
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