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Cognitive impairment predicts mortality in outpatient veterans with heart failure

Howard Lan1, Lee Ann Hawkins2, Michael Kashner3

  • 1Loma Linda University Medical Center, 11234 Anderson St, Loma Linda, CA 92354, USA; VA Loma Linda Healthcare System, 11201 Benton St, Loma Linda, CA 92357, USA.

Heart & Lung : the Journal of Critical Care
|August 26, 2018
PubMed

Insights

Cognitive impairment (CI) in heart failure (HF) patients significantly increases mortality risk. Routine cognitive screening is recommended for early identification and intervention in high-risk individuals.

Area of Science:

  • Cardiology
  • Neurology
  • Geriatrics

Background:

  • A prior study found 58% of heart failure (HF) patients had unrecognized cognitive impairment (CI), linked to poor medication adherence.
  • Existing literature indicates CI in HF patients is associated with worse clinical outcomes, including increased mortality.

Purpose of the Study:

  • To investigate and compare all-cause mortality rates in outpatients with HF and undiagnosed CI versus those without CI.

Main Methods:

  • Retrospective study design.
  • Analysis of all-cause mortality over a 3-year follow-up period.
  • Comparison of mortality rates across groups with no CI, mild CI, and severe CI.

Main Results:

  • Overall, 25.6% of patients died within 3 years.
  • Patients with CI had a significantly increased risk of mortality (HR 1.82, p=0.038).
  • Severe CI was associated with the worst outcomes (HR 2.710, p=0.011).

Conclusions:

  • Cognitive impairment is an independent risk factor for mortality in heart failure patients.
  • Cognitive screening is crucial for identifying HF patients at higher risk of adverse outcomes.
  • Routine cognitive assessment can guide proactive management strategies in HF care.
Abstract

Keywords:
Abbreviations: BNP, B-type natriuretic peptideCI, cognitive impairmentCognitionCognitive impairmentHF, heart failureHR, hazard ratioHeart failureLVEF, left ventricular ejection fractionMortalitySBP, systolic blood pressureSLUMS, Saint Luis University Mental StatusVA, veterans affairs

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