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Heart Failure and Cognitive Impairment in the Atherosclerosis Risk in Communities (ARIC) Study

Lucy S Witt1, Jason Rotter2, Sally C Stearns3

  • 1Department of Hospital Medicine, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA. lucyswitt@gmail.com.

Journal of General Internal Medicine
|July 22, 2018
PubMed

Insights

Heart failure (HF) is linked to cognitive impairment and faster decline. This study found HF patients had higher rates of dementia and mild cognitive impairment (MCI).

Area of Science:

  • Neurology and Cardiology
  • Cognitive Science
  • Epidemiology

Background:

  • Heart failure (HF) is increasingly recognized as a potential risk factor for cognitive decline.
  • Understanding the relationship between HF, cognitive status, and cognitive decline in community samples is crucial for clinical risk assessment.
  • Existing research suggests a link, but further investigation in diverse populations is warranted.

Purpose of the Study:

  • To determine if individuals with prevalent heart failure exhibit a higher prevalence of cognitive impairment.
  • To investigate whether individuals who develop heart failure experience a more accelerated rate of cognitive decline over time.
  • To analyze the association between heart failure and cognitive status in a community-based cohort.

Main Methods:

  • An observational cohort study utilizing data from the Atherosclerosis Risk in Communities (ARIC) study.
  • Cross-sectional analysis employed multinomial logistic regression to assess prevalent HF and cognitive status.
  • Longitudinal analysis examined the association between incident HF and cognitive change over a 15-year period, controlling for socio-demographic and vascular factors.

Main Results:

  • Participants with heart failure showed a significantly higher prevalence of dementia (RRR=1.60) and mild cognitive impairment (MCI) (RRR=1.36) compared to those without HF.
  • Individuals who developed incident heart failure experienced a greater decline in cognitive function over 15 years (-0.07 SD units) than those who did not develop HF.
  • These associations remained significant after adjusting for potential confounders and did not vary based on ejection fraction.

Conclusions:

  • Heart failure is independently associated with neurocognitive dysfunction and decline.
  • The findings highlight a significant link between HF and impaired cognitive status, independent of other comorbidities.
  • Further research is necessary to elucidate the underlying pathophysiological mechanisms connecting heart failure and cognitive impairment.
Abstract

Keywords:
cognitive declinecognitive impairmentdementiaheart failure

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