Emily C Gathright1,2,3, Mary A Dolansky4, John Gunstad1, Richard A Josephson5,6, Shirley M Moore4, Joel W Hughes1. 1. Department of Psychological Sciences, Kent State University, USA. 2. Centers for Behavioral and Preventive Medicine, The Miriam Hospital, USA. 3. Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, USA. 4. Frances Payne Bolton School of Nursing, Case Western Reserve University, USA. 5. School of Medicine, Case Western Reserve University, USA. 6. Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, USA.
Abstract
BACKGROUND: The prevalence and impact of cognitive impairment in heart failure is increasingly recognized. Converging evidence points to global cognitive function as predictive of prognosis in adults with heart failure when assessed with screening tools. Additional work is needed to understand which domains of cognitive function are most relevant for prognosis. AIMS: The present study sought to examine associations between domains of cognitive function and mortality risk in adults with heart failure. METHODS: In the present prospective, observational cohort study, global cognitive function, attention, executive function, and memory were assessed by means of a comprehensive neuropsychogical battery in adults with systolic heart failure. Mortality data were obtained from the National Death Index (median follow-up 2.95 years). Relationships among each cognitive domain and mortality were assessed with Cox regression. Covariates included age, sex, heart failure severity, comorbidity and depressive symptoms. RESULTS: Participants were 325 patients with systolic heart failure with a mean age of 68.6 years (59% men, 73% Caucasian). Following covariate adjustment, better global cognitive function, attention, and executive function were related to decreased mortality risk. CONCLUSIONS: Future research is needed to clarify the underlying mechanisms of the association between cognitive impairment and mortality.
BACKGROUND: The prevalence and impact of cognitive impairment in heart failure is increasingly recognized. Converging evidence points to global cognitive function as predictive of prognosis in adults with heart failure when assessed with screening tools. Additional work is needed to understand which domains of cognitive function are most relevant for prognosis. AIMS: The present study sought to examine associations between domains of cognitive function and mortality risk in adults with heart failure. METHODS: In the present prospective, observational cohort study, global cognitive function, attention, executive function, and memory were assessed by means of a comprehensive neuropsychogical battery in adults with systolic heart failure. Mortality data were obtained from the National Death Index (median follow-up 2.95 years). Relationships among each cognitive domain and mortality were assessed with Cox regression. Covariates included age, sex, heart failure severity, comorbidity and depressive symptoms. RESULTS: Participants were 325 patients with systolic heart failure with a mean age of 68.6 years (59% men, 73% Caucasian). Following covariate adjustment, better global cognitive function, attention, and executive function were related to decreased mortality risk. CONCLUSIONS: Future research is needed to clarify the underlying mechanisms of the association between cognitive impairment and mortality.
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