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The Prevalence of Cognitive Impairment Among Adults With Incident Heart Failure: The "Reasons for Geographic and
Madeline R Sterling1, Deanna Jannat-Khah1, Joanna Bryan1
1Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York.
Insights
Cognitive impairment (CI) affects 14.9% of newly diagnosed heart failure (HF) patients, similar to those without HF. Most cognitive decline in heart failure likely occurs after diagnosis, warranting increased awareness and management strategies.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- Cognitive impairment (CI) affects a significant portion of heart failure (HF) patients, with prevalence estimates ranging widely.
- The prevalence of CI specifically at the time of incident HF diagnosis remains unclear.
- Understanding cognition in HF is crucial for comprehensive patient management.
Purpose of the Study:
- To determine the prevalence of CI in adults newly diagnosed with heart failure (HF).
- To compare CI prevalence in incident HF patients versus a matched cohort without HF.
- To identify factors associated with CI in the context of incident HF.
Main Methods:
- Utilized data from the REGARDS longitudinal cohort study (2003-2007).
- Included adults aged 45 and older with expert-adjudicated incident HF.
- Assessed cognitive function using the Six-Item Screener and compared with an age-, sex-, and race-matched non-HF cohort.
Main Results:
- The study included 436 participants with incident HF (mean age 70.3 years; 47% female; 39% black).
- Prevalence of CI in incident HF patients was 14.9%, statistically similar to the non-HF cohort (13.4%).
- Factors associated with CI included older age, black race, female sex, lower education, and anticoagulation use.
Conclusions:
- Approximately 14.9% of adults with incident HF exhibit cognitive impairment at diagnosis.
- The findings suggest that significant cognitive decline in HF patients often manifests after the initial diagnosis.
- Increased awareness and mitigation strategies for CI in newly diagnosed HF patients are recommended.
Background:
Cognitive impairment (CI) is estimated to be present in 25%-80% of heart failure (HF) patients, but its prevalence at diagnosis is unclear. To improve our understanding of cognition in HF, we determined the prevalence of CI among adults with incident HF in the REGARDS study.
Methods And Results:
REGARDS is a longitudinal cohort study of adults ≥45 years of age recruited in the years 2003-2007. Incident HF was expert adjudicated. Cognitive function was assessed with the Six-Item Screener. The prevalence of CI among those with incident HF was compared with the prevalence of CI among an age-, sex-, and race-matched cohort without HF. The 436 participants with incident HF had a mean age of 70.3 years (SD 8.9), 47% were female, and 39% were black. Old age, black race, female sex, less education, and anticoagulation use were associated with CI. The prevalence of CI among participants with incident HF (14.9% [95% CI 11.7%-18.6%]) was similar to the non-HF matched cohort (13.4% [11.6%-15.4%]; P < .43).
Conclusions:
A total of 14.9% of the adults with incident HF had CI, suggesting that the majority of cognitive decline occurs after HF diagnosis. Increased awareness of CI among newly diagnosed patients and ways to mitigate it in the context of HF management are warranted.