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Frequent Cognitive Impairment in Patients With Disorders Along the Heart-Brain Axis

Astrid M Hooghiemstra1,2, Anna E Leeuwis1, Anne Suzannne Bertens3,4

  • 1From the Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience (A.M.H., A.E.L., W.M.v.d.F.), Amsterdam UMC, location VUmc, the Netherlands.

Stroke
|November 6, 2019
PubMed

Insights

Patients with heart failure (HF) and carotid occlusive disease (COD) frequently experience cognitive impairment. Memory and attention were most affected, highlighting the need for vigilance and integrated care for heart-brain axis disorders.

Area of Science:

  • Neurology
  • Cardiology
  • Cognitive Science

Background:

  • Cardiovascular disease (CVD) is linked to an increased risk of cognitive decline.
  • Hemodynamic disturbances in the heart-brain axis can impact cognitive function.
  • Three patient groups (heart failure, carotid occlusive disease, possible vascular cognitive impairment) were studied.

Purpose of the Study:

  • To investigate the occurrence and profile of cognitive impairment in patients with conditions affecting the heart-brain axis.
  • To compare cognitive functioning across different patient groups and a reference group.

Main Methods:

  • 555 participants (160 HF, 107 COD, 160 possible VCI, 128 reference) underwent comprehensive cognitive testing.
  • Cognitive scores were transformed into z-scores for memory, language, attention/psychomotor speed, executive functioning, and global cognition.
  • Impairment was defined as a z-score ≤-1.5; patients were classified as cognitively normal, minor, or major impairment.

Main Results:

  • Global cognitive functioning was lower in patients with carotid occlusive disease (COD) and possible vascular cognitive impairment (VCI) compared to controls.
  • Patients with heart failure (HF) showed lower scores in attention/speed and language.
  • Cognitive impairment rates were 18% (HF), 36% (COD), and 45% (possible VCI). Memory and attention/psychomotor speed were the most affected domains.

Conclusions:

  • A significant proportion of patients with HF and COD exhibit cognitive impairment.
  • Vigilance for cognitive impairment in these patient groups is crucial.
  • An integrated medical approach is vital for managing patients with heart-brain axis disorders.

Keywords:
braincerebral small vessel diseasescognitive impairmentdementiaheart failure

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