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Cognitive Decline Over Time in Patients With Systolic Heart Failure: Insights From WARCEF
Tetz C Lee1, Min Qian1, Yutong Liu1
1Columbia University Medical Center, New York, NY.
JACC. Heart Failure
|November 30, 2019
Summary
Cognitive decline in heart failure patients is linked to higher baseline cognitive scores, older age, nonwhite race, and lower education. Frequent cognitive assessments are recommended for heart failure patients.
Area of Science:
- Cardiology
- Neurology
- Geriatrics
Background:
- Cognitive decline (CD) is prevalent in heart failure (HF) patients and impacts mortality.
- Predictors of CD in HF remain largely unestablished, necessitating further investigation.
Purpose of the Study:
- To characterize the progression of cognitive decline over time in patients with systolic heart failure.
- To identify key predictors associated with cognitive decline in this population.
Main Methods:
- Analysis of data from the Warfarin versus Aspirin in Reduced Ejection Fraction (WARCEF) trial.
- Longitudinal time-varying analysis using yearly Mini-Mental State Examinations (MMSE) scores.
- Inclusion of baseline MMSE, demographic variables, and New York Heart Association (NYHA) functional class as covariates.
Main Results:
- Cognitive decline was independently associated with higher baseline MMSE scores, older age, nonwhite race/ethnicity, and lower education levels.
- New York Heart Association functional class II or higher also predicted cognitive decline.
- Warfarin and other medications showed no association with cognitive decline.
Conclusions:
- Baseline cognitive status, demographic factors, and NYHA functional class are significant predictors of cognitive decline in HF patients.
- The identified predictors suggest that interventions may be possible, highlighting the importance of regular cognitive function assessment in HF management.
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