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Neurocognitive Changes Associated With Heart Failure: A Narrative Review.
Tao Zheng1, Kristoffer Rhoads2, Cynthia M Dougherty3
1Tao Zheng is Clinical Practice Specialist at the American Association of Critical-Care Nurses, Aliso Viejo, California; Affiliate Assistant Professor, University of Washington School of Nursing; and Registered Nurse at University of Washington Medical Center, 1959 NE Pacific St, Seattle, WA 98195 (zhengtao@uw.edu).
AACN Advanced Critical Care
|February 27, 2026
Summary
Heart failure often causes cognitive impairment due to reduced cardiac function and brain blood flow. Early screening and management are crucial for improving outcomes in patients with heart failure-related cognitive impairment.
Area of Science:
- Cardiology
- Neurology
- Cognitive Science
Background:
- Heart failure affects up to 80% of individuals, leading to cognitive impairment.
- This impairment is linked to reduced cardiac function and cerebral hypoperfusion, resulting in brain injury.
- Neuropsychological changes are common in heart failure patients.
Purpose of the Study:
- Identify causes of heart failure-related cognitive impairment.
- Synthesize literature on indicators and mechanisms of cognitive decline.
- Discuss affected cognitive domains and clinical implications.
Main Methods:
- This study is a narrative review of empirical studies.
- Included studies focused on cognitive performance in individuals with heart failure.
- Studies were in English and utilized original data.
Main Results:
- Cognitive impairment correlates with heart failure severity, reduced ejection fraction, and lower systolic blood pressure.
- Cerebral hypoperfusion, microembolic events, and brain abnormalities contribute to cognitive deficits.
- Deficits are observed in attention, memory, and executive function.
Conclusions:
- Further research is needed on cerebral hemodynamics and cognitive function.
- Identifying early decline markers and optimizing screening are essential.
- Integrating cognitive screening into routine care may improve patient outcomes.
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