Background: Many chronic heart failure patients exhibit cognitive impairments, which may further complicate disease management by undermining treatment adherence, diminishing independence, and reducing overall quality of life. Despite ongoing advances in research and clinical management, early identification and prevention of cognitive impairment remains a challenge, in particular in remote areas. This study aims to provide a comprehensive description of the cognitive profile of chronic heart failure participants while taking into account disease phenotype and individual factors. The study uses validated tools for remote assessment.
METHODS AND RESULTS: Fifty-three participants with chronic heart failure (mean age 68.58 ± 9.26; 64% with reduced ejection fraction (EF) with a mean LVEF of 32.43%; 13% with midrange EF with a mean LVEF of 44.63%, and 13% preserved EF with a mean LVEF of 55.56%) underwent a remote standardised neuropsychological assessment of global cognition, working memory, episodic memory, verbal fluency and abstraction. Each test score was Z-score standardised using available normative data that took into account the individual’s age, sex and education. In the sample, 32% of participants had impaired cognitive performance (-1.5 standard deviations from the population average), and 47% showed cognitive weakness (between -0.6 and -1.5 standard deviations bellow the population average) in at least one cognitive domain. Episodic memory and executive functioning were mainly affected. No cognitive differences were observed between men and women, or between different chronic heart failure phenotypes.
Conclusion: Results underline the importance of neuropsychological assessment in chronic heart failure patients. The prevalence of mild cognitive impairment in chronic heart failure patients is substantial, but so is the fact that almost one in two patients has subclinical cognitive weakness. The treatment and prevention of cognitive impairment should be one of our main concerns if we are to successfully tackle the dual burden of chronic heart failure patients. The study also shows that remote cognitive assessments could be used in heart failure patients to screen and identify those that need more urgent interventions.
