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[Cognitive impairment in patients with chronic heart failure and its impact on adherence to treatment]
Y O Aksenova1, A A Petrukhina1, Y F Osmolovskaya1
1Chazov National Medical Research Center of Cardiology.
Insights
Cognitive impairment is common in chronic heart failure (CHF). Patients with better cognitive function and treatment adherence showed improved outcomes and were more motivated for follow-up care.
Area of Science:
- Cardiology
- Neurology
- Psychology
Context:
- Chronic heart failure (CHF) is associated with cognitive impairment.
- Understanding this relationship is crucial for patient management.
- Limited research exists on the impact of cognitive function on treatment adherence in CHF patients.
Purpose:
- To evaluate cognitive impairment in 120 hospitalized chronic heart failure (CHF) patients.
- To assess the impact of cognitive impairment on treatment adherence and quality of life.
- To compare outcomes between patients who attended a 6-month follow-up and those who did not.
Summary:
- 120 CHF patients underwent neuropsychological testing. After 6 months, 28 attended follow-up, 3 died, and 89 refused.
- Follow-up patients showed improved MoCA scores (23.89±2.67, p=0.003), with 53.6% demonstrating cognitive improvement.
- A medium correlation between treatment adherence and cognitive function was observed in the follow-up group, versus a weak correlation in the non-attendee group.
Impact:
- Cognitive impairment significantly affects chronic heart failure management.
- Comprehensive patient care addressing cognitive function is essential.
- Patients with higher cognitive function and treatment adherence are more motivated for follow-up.
Aim:
To evaluate cognitive impairment in patients with chronic heart failure (CHF) and its impact on treatment adherence.
Materials And Methods:
The study included 120 hospitalized patients with CHF regardless of left ventricular ejection fraction aged from 20 to 79 years with different etiology of CHF. All patients underwent complex neuropsychological testing to determine the presence and severity of CH, psychoemotional status, as well as adherence to treatment and quality of life. After 6 months, the group of patients who came for a follow-up visit was re-evaluated for these indicators. The first group of patients was compared with the second group of patients who did not come for a follow-up visit after 6 months, although the conditions of the study were explained to all single patients.
Results:
Out of 120 patients, 28 (23.3%) patients came for a follow-up visit, 3 (2.5%) patients died, the rest of the study participants [89 (74.2%) patients] - refused a face-to-face visit to the physician. On MoCA after 6 months, patients showed a higher mean score of 23.89±2.67 (p=0.003). Percentage-wise, 53.6% of patients showed improvement in cognitive functioning scores. Group 1 patients (n=28) demonstrated a medium relationship between treatment adherence on the Morisky-Green questionnaire and RBM-7 (r=-0.532) in contrast to group 2 patients (n=89) who demonstrated a weak relationship (r=-0.283).
Conclusion:
The complex relationship between CHF and cognitive impairment emphasizes the need for a comprehensive approach to patient care. Patients who demonstrate high compliance and good subjective assessment of their cognitive functioning, although some cognitive functions are reduced, are the most motivated to comply with the doctor's recommendations and follow-up.
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