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Congestive heart failure and cognitive impairment in an older population. Osservatorio Geriatrico Campano Study Group
F Cacciatore1, P Abete, N Ferrara
1Cattedra di Geriatria, Istituto di Medicina Interna, Cardiologia e Chirurgia Cardiovascolare, Università degli Studi di Napoli Federico II, Naples, Italy.
Insights
Congestive heart failure (CHF) is linked to cognitive impairment (CI) in older adults. Those with CHF face a nearly twofold higher risk of CI, highlighting CHF as a significant factor in cognitive decline.
Area of Science:
- Gerontology
- Cardiology
- Neurology
Background:
- Congestive heart failure (CHF) is a growing concern in aging populations.
- Identifying modifiable risk factors for cognitive impairment (CI) is crucial for older adults.
- This study investigates the relationship between CHF and CI in individuals aged 65 and above.
Purpose of the Study:
- To examine the cross-sectional association between congestive heart failure (CHF) and cognitive impairment (CI) in an elderly population.
- To determine if CHF is an independent risk factor for CI in older adults.
- To explore potential physiological markers associated with CI in CHF patients.
Main Methods:
- A cross-sectional survey was conducted with 1339 participants aged 65+ in Southern Italy.
- Data collected included sociodemographic factors, cardiovascular diseases (CHF by NYHA class), cognitive function (MMSE), depression (GDS), blood pressure, and heart rate.
- Logistic regression analysis was used to identify independent associations, with 1075 subjects included in the final analysis.
Main Results:
- The prevalence of CHF was 8.2%, and 23.0% of participants exhibited CI (MMSE <24).
- CHF was independently associated with CI, with individuals with CHF showing a 1.96-fold increased risk of CI (OR: 1.96; 95% CI: 1.07-3.58).
- Systolic blood pressure decrease correlated with NYHA classes in CI subjects, while heart rate increase correlated with NYHA classes in non-CI subjects.
Conclusions:
- Congestive heart failure is significantly associated with cognitive impairment in individuals aged 65 and older.
- Specific hemodynamic patterns, such as reduced systolic blood pressure and lack of heart rate increase relative to CHF severity, may characterize cognitively impaired patients.
- These findings underscore the importance of managing CHF to potentially mitigate cognitive decline in the elderly.
Objective:
Congestive heart failure (CHF) is potentially preventable, and the identification of modifiable risk factors for cognitive impairment (CI) for older persons is a very important issue. We examined the cross-sectional relationship between CHF and CI in an older population.
Design:
A cross-sectional survey.
Setting And Participants:
A total of 1339 subjects aged 65 and older were selected from the electoral rolls of Campania, a region of southern Italy.
Measurements:
Sociodemographic characteristics were recorded, as was the presence of cardiovascular diseases, including CHF classified according to the New York Heart Association (NYHA) guidelines for disease severity; CI evaluated by means of the Mini-Mental State Examination (MMSE), with a score of <24 indicating impairment; geriatric depression scale (GDS) rating; blood pressure (BP); and heart rate (HR).
Results:
The final sample numbered 1075; 172 subjects were excluded because of neurological disorders and psychotropic therapy, and 92 were excluded because their BP, HR, or cognitive examination was not recorded. Prevalence of CHF was 8.2%, and 23.0% of subjects scored <24 on the MMSE. The prevalence of CHF in subjects with an MMSE score of <24 and > or =24 was 20.2% and 4.6%, respectively (P < .001). Logistic regression analysis showed that CHF was associated independently with CI by sex, age, educational level, GDS, diabetes, hypertension, alcohol consumption, smoking, atrial fibrillation, systolic and diastolic BP, and HR. The risk of CI was 1.96-fold greater in subjects with CHF (odds ratio: 1.96; 95% confidence interval: 1.07-3.58; P < .028). Systolic BP decrease was correlated negatively with NYHA classes only in subjects with CI (r = -0.981; P < .020), whereas HR increase was correlated positively with NYHA classes only in subjects without CI (r = 0.985; P < .015).
Conclusions:
In our population, CHF is associated with CI in subjects aged 65 years and older. Systolic BP reduction and the lack of HR increase, related to NYHA classes, might characterize cognitively impaired subjects with CHF.