Cognition in Chronic Heart Failure: Advancing Knowledge for Better Prevention Through Remote Assessment

Cognitive impairment is an important comorbidity of chronic heart failure (CHF) and may be associated with major complications. Despite ongoing advances in research and clinical management, early identification and prevention of cognitive impairment remain challenging. This study aims to provide a comprehensive description of the cognitive profile of participants with CHF using baseline data from the Effects of Individualized Cognitive Training on Cognition in Heart Failure (SYNAPSE) trial.

A total of 53 participants with CHF (aged, mean [ ± standard deviation] 68.58 ± 9.26 years; 54.7% men; 64% with heart failure with reduced ejection fraction, with a left ventricular ejection fraction of 32.43%) were approached and agreed to participate in the SYNAPSE trial. They underwent a remote baseline neuropsychological assessment of global cognition, working and short-term memory, episodic memory, executive functioning, and abstraction ability. Scores were computed in standardized z-scores that consider age, sex, and education, based on normative data.

A total of 68% of participants had impairment (-1.5 standard deviations from the population norms) in at least one cognitive domain. Episodic memory and executive functioning were mainly affected. Among those with no impairment, 26% of participants presented scores that fell within the low average range of the population (-0.66 standard deviations). No cognitive differences were observed between men and women, or between different CHF phenotypes.

The results underline the importance of neuropsychological assessment in CHF patients. Mild cognitive impairment in CHF patients is prevalent, but even more patients are susceptible to subclinical cognitive weakness. Prevention and treatment of these deficits are of major importance for optimal disease management.

NCT05223426.