Cognitive impairment in heart failure patients

Laura Leto, Mauro Feola, Laura Leto, Mauro Feola

Abstract

Cognitive damage in heart failure (HF) involves different domains thus interfering with the ability for single patient to self-care and to cope with treatment regimens, modifying symptoms and health behaviours. Many cerebral and functional changes were detected in brain imaging, involving areas of both grey and white matter deputed to cognition. Although various instruments are available to explore cognition, no consensus was obtained on better tools to be used in HF population. Reduction in cerebral blood flow, decreased cardiac output, alterations of cerebrovascular reactivity and modification of blood pressure levels are the main features involved in the etiopathogenetic mechanisms of cognitive deficit. Several cardiac variables, laboratory parameters, demographic and clinical elements were studied for their possible relation with cognition and should be properly evaluated to define patients at increased risk of impairment. The present review gathers available data pointing out assured information and discussing possible areas of research development.

Keywords: Blood pressure; Cognitive impairment; Heart failure.

References

    1. Mosterd A, Hoes AW. Clinical epidemiology of heart failure. Heart. 2007;93:1137–1146.
    1. Harkness K, Demers C, et al. Screening for cognitive deficits using the Montreal cognitive assessment tool in outpatients ≥ 65 years of age with heart failure. Am J Cardiol. 2011;107:1203–1207.
    1. Davis K, Mintzer M, Himmelfarb CRD, et al. Targeted intervention improves knowledge but not self-care or readmissions in heart failure patients with mild cognitive impairment. Eur J Heart Fail. 2012;14:1041–1049.
    1. Grubb NR, Simpson C, Fox KAA. Memory function in patients with stable, moderate to severe cardiac failure. Am Heart J. 2000;140:e1.
    1. Liang SY, Li XP. Recognition of depression/anxiety-complicated coronary diseases and evaluation of commonly used scales. J Translat Intern Med. 2014;1:26–31.
    1. Miller LA, Spitznagel MB, Alosco M, et al. Cognitive profiles in heart failure: a cluster analytic approach. J Clin Exp Neuropsychol. 2012;34:509–520.
    1. Vogels RLC, Scheltens P, et al. Cognitive impairment in heart failure: a systematic review of the literature. Eur J Heart Fail. 2007;9:440–449.
    1. Bauer LC, Johnson JK, Pozehl BJ. Cognition in heart failure: an overview of the concepts and their measures. J Am Acad Nurse Pract. 2011;23:577–585.
    1. Dardiotis E, Giamouzis G, Mastrogiannis D, et al. Cognitive impairment in heart failure. Cardiol Res Pract. 2012:595821.
    1. Pressler SJ, Subramanian U, Kareken D, et al. Cognitive deficits in chronic heart failure. Nurs Res. 2010;59:127–139.
    1. Hajduk AM, Lemon SC, McManus DD, et al. Cognitive impairment and self-care in heart failure. Clin Epidemiol. 2013;5:407–416.
    1. Athilingam P, D'Aoust RF, et al. Cognitive profile in persons with systolic and diastolic heart failure. Congest Heart Fail. 2013;19:44–50.
    1. Hjelm C, Dahl A, Brostrom A, et al. The influence of heart failure on longitudinal changes in cognition among individuals 80 years of age and older. J Clin Nurs. 2011;21:994–1003.
    1. Schmidt R, Fazekas F, Offenbacher H, et al. Brain magnetic resonance imaging and neuropsychologic evaluation of patients with idiopathic dilated cardiomyopathy. Stroke. 1991;22:195–199.
    1. Woo MA, Macey PM, Fonarow GC, et al. Regional brain grey matter loss in heart failure. J Appl Physiol. 2003;95:677–684.
    1. Kumar R., Woo MA, Birrer BVX, et al. Mammillary bodies and fornix fibers are injured in heart failure. Neurobiol Dis. 2009;33:236–242.
    1. Kumar R., Nguyen HD, Ogren JA, et al. Global and regional putamen volume loss in patients with heart failure. Eur J Heart Fail. 2011;13:651–655.
    1. Lee CW, Lee JH, Kim JJ, et al. Cerebral metabolic abnormalities in congestive heart failure detected by proton magnetic resonance spectroscopy. J Am Coll Cardiol. 1999;33:1196–1202.
    1. Hong X, Bu L, Wang Y, et al. Increases in the risk of cognitive impairment and alterations of cerebral β-amyloid metabolism in mouse model of heart failure. PLoS ONE. 2013;8:e63829.
    1. Alves TC, Rays J, Fraguas R, et al. Localized cerebral blood flow reductions in patients with heart failure: a study using 99mTC-HMPAO SPECT. J Neuroimaging. 2005;15:150–156.
    1. Georgiadis D., Sievert M., Cencetti S, et al. Cerebrovascular reactivity is impaired in patients with cardiac failure. Eur Heart J. 2000;21:407–413.
    1. Bornstein RA, Starling RC, Myerowitz PD, et al. Neuropsychological function in patients with end-stage heart failure before and after cardiac transplantation. Acta Neurol Scand. 1995;91:260–265.
    1. Roman DD, Kubo SH, Ormaza S, et al. Memory improvement following cardiac transplantation. J Clin Exp Neuropsychol. 1997;19:962–967.
    1. Jefferson AL, Himali JJ, Beiser AS, et al. Cardiac index is associated with brain aging. The Framingham Heart Study. Circulation. 2010;122:690–697.
    1. Jefferson AL, Poppas A, Paul RH, et al. Systemic hypoperfusion is associated with executive dysfunction in geriatric cardiac patients. Neurobiol Aging. 2007;28:477–483.
    1. Zuccalà G, Onder G, Pedone C, et al. Hypotension and cognitive impairment: selective association in patients with heart failure. Neurology. 2001;57:1986–1992.
    1. Vogels RL, Oosterman JM, van Harten B, et al. Neuroimaging and correlates of cognitive function among patients with heart failure. Dement Geriatr Cogn Disord. 2007;24:418–423.
    1. Alosco ML, Spitznagel MB, Gunstad J. Obesity as a risk factor for poor neurocognitive outcomes in older adults with heart failure. Heart Fail Rev. 2014;19:403–411.
    1. Alosco ML, Spitznagel MB, Raz N, et al. Obesity interacts with cerebral hypoperfusion to exacerbate cognitive impairment in older adults with heart failure. Cerebrovasc Dis Extra. 2012;2:88–98.
    1. Sohani ZN, Samaan Z. Does depression impact cognitive impairment in patients with heart failure? Cardiol Res Pract. 2012:524325.
    1. Alosco ML, Spitznagel MB, Raz N, et al. The interactive effects of cerebral perfusion and depression on cognitive function in older adults with heart failure. Psychosom Med. 2013;75:632–639.
    1. Zuccalà G, Cattel C, Manes-Gravina E, et al. Left ventricular dysfunction: a clue to cognitive impairment in older patients with heart failure. J Neurol Neruosurg Psych. 1997;63:509–512.
    1. Moser DJ, Cohen RA, Clark MM, et al. Neuropsychological functioning among cardiac rehabilitation patients. J Cardiopulm Rehabil. 1999;19:91–97.
    1. Steinberg G, Lossnitzer N, Schellberg D, et al. Peak oxygen uptake and left ventricular ejection fraction, but not depressive symptoms, are associated with cognitive impairment in patients with chronic heart failure. Int J Gen Med. 2011;4:879–887.
    1. Festa JR, Jia X, Cheung K, et al. Association of low ejection fraction with impaired verbal memory in older patients with heart failure. Arch Neurol. 2011;68:1021–1026.
    1. Jefferson AL, Himali JJ, Au R, et al. Relation of left ventricular ejection fraction to cognitive aging (from the Framingham Heart Study) Am J Cardiol. 2011;108:1346–1351.
    1. Bhattacharya P, Bao F, Shah M, et al. Left ventricular dysfunction is associated with cerebral grey matter injury: an in-vivo brain MRI segmentation study. J Neurol Sci. 2012;321:111–113.
    1. Vogels RLC, Oosterman JM, van Harten B, et al. Profile of cognitive impairment in chronic heart failure. J Am Geriatr Soc. 2007;55:1764–1770.
    1. Van den Hurk K, Reijmer YD, ven den Berg E, et al. Heart failure and cognitive function in the general population: the Hoorn Study. Eur J Heart Fail. 2011;13:1362–1369.
    1. Cacciatore F, Abete P, Ferrara N, et al. Congestive heart failure and cognitive impairment in an older population. J Am Geriatr Soc. 1998;46:1343–1348.
    1. Zuccalà G, Marzetti E, Cesari M, et al. Correlates of cognitive impairment among patients with heart failure: results of a multicenter survey. Am J Med. 2005;118:496–502.
    1. Trojano L, Antonelli Incalzi R, Acanfora D, et al. Cognitive impairment: a key feature of congestive heart failure in the elderly. J Neurol. 2003;250:1456–1463.
    1. Riegel B, Bennett JA, Davis A, et al. Cognitive impairment in heart failure: issues of measurement and etiology. Am J Crit Care. 2002;11:520–528.
    1. Qiu C, Winblad B, Marengoni A, et al. Heart failure and risk of dementia and Alzheimer disease. Arch Intern Med. 2006;166:1003–1008.
    1. Kerola T, Nieminen T, Hartikainen S, et al. B-type natriuretic peptide as a predictor of declining cognitive function and dementia–a cohort study of an elderly general population with a 5-year follow-up. Ann Med. 2010;42:207–215.
    1. Daniels LB, Laughlin GA, Kritz-Silverstein D, et al. Elevated natriuretic peptide levels and cognitive function in community-dwelling older adults. Am J Med. 2011;124:670e1–e8.
    1. Gunstad J, Poppas A, Smeal S, et al. Relation of brain natriuretic peptide levels to cognitive dysfunction in adults > 55 years of age with cardiovascular disease. Am J Cardiol. 2006;98:538–540.
    1. Feola M, Rosso GL, Peano M, et al. Correlation between cognitive impairment and prognostic parameters in patients with congestive heart failure. Arch Med Res. 2007;38:234–239.
    1. Debette S, Bauters C, Leys D, et al. Prevalence and determinants of cognitive impairment in chronic heart failure patients. Congest Heart Fail. 2007;13:205–208.
    1. Baldasseroni S, Mossello E, Romboli B, et al. Relationship between cognitive function and 6-minute walking test in older outpatients with chronic heart failure. Aging Clin Exp Res. 2010;22:308–313.
    1. Gaviria M, Pliskin N, Kney A. Cognitive impairment in patients with advanced heart failure and its implication on decision-making capacity. Congest Heart Fail. 2011;17:175–179.
    1. Dickson VV, Tkacs N, Riegel B. Cognitive influences on self-care decision making in persons with heart failure. Am Heart J. 2007;154:424–431.
    1. Riegel B, Carlson B, Moser DK, et al. Psychometric testing of the self-care of heart failure index. J Card Fail. 2004;10:350–360.
    1. Riegel B, Lee CS, Dickson VV, et al. An update on the self-care of heart failure index. J Cardiovasc Nurs. 2009;24:485–497.
    1. Cameron J, Worrall-Carter L, Page K, et al. Does cognitive impairment predict poor self-care in patients with heart failure? Eur J Heart Fail. 2010;12:508–512.
    1. Cameron J, Ski CF, McLennan SN, et al. Development of the Heart failure Screening Tool (Heart-FAST) to measure barriers that impede engagement in self-care. Eur J Cardiovasc Nurs. 2014;13:408–417.
    1. Davis KK, Dennison Himmelfarb CR, Szanton SL, et al. Predictors of heart failure self-care in patients who screened positive for mild cognitive impairment. J Cardiovasc Nurs. 2014 Published online first Jan 14, 2014.
    1. Cline CM, Bjorck-Linnè AK, Israelsson BY, et al. Non-compliance and knowledge of prescribed medication in elderly patients with heart failure. Eur J Heart Fail. 1999;1:145–149.
    1. Hawkins LA, Kilian S, Firek A, et al. Cognitive impairment and medication adherence in outpatients with heart failure. Heart Lung. 2012;41:572–582.
    1. Zuccalà G, Pedone C, Cesari M, et al. The effects of cognitive impairment on mortality among hospitalized patients with heart failure. Am J Med. 2003;115:97–103.
    1. Nardi R, Fiorino S, Borioni D, et al. Comprehensive complexity assessment as a key tool for the prediction of in-hospital mortality in heart failure of aged patients admitted to internal medicine wards. Arch Gerontol Geriatr. 2007;44:279–288.
    1. Harkness K, Heckman GA, McKelvie RS. The older patient with heart failure: high risk for frailty and cognitive impairment. Expert Rev Cardiovasc Ther. 2012;10:779–795.
    1. Pressler SJ, Kim JS, Riley P, et al. Memory dysfunction, psychomotor slowing and decreased executive function predict mortality in patients with heart failure and low ejection fraction. J Card Fail. 2010;16:750–760.
    1. Dodson JA, Tuyet-Trinh NT, Towle VR, et al. Cognitive impairment in older adults with heart failure: prevalence, documentation and impact on outcomes. Am J Med. 2013;126:120–126.
    1. Okonkwo OC, Cohen RA, Gunstad J, et al. Longitudinal trajectories of cognitive decline among older adults with cardiovascular disease. Cerebrovasc Dis. 2010;30:363–373.
    1. Stanek GM, Gunstad J, Paul RH, et al. Longitudinal cognitive performance in older adults with cardiovascular disease: evidence for improvement in heart failure. J Cardiovasc Nurs. 2009;24:192–197.
    1. Alosco ML, Garcia S, Spitznagel MB, et al. Cognitive performance in older adults with stable heart failure: longitudinal evidence for stability and improvement. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2014;21:239–256.
    1. Riegel B, Lee CS, Glaser D, et al. Patterns of change in cognitive function over six months in adults with chronic heart failure. Cardiol Res Pract. 2012:631075.
    1. Hajduk AM, Kiefe CL, Person SD, et al. Cognitive change in heart failure: a systematic review. Circ Cardiovasc Qual Outcomes. 2013;6:451–460.
    1. Huijts M, van Oostenbrugge RJ, Duits A, et al. Cognitive impairment in heart failure: results from the Trial of Intensified versus standard Medical therapy in Elderly patients with Congestive Heart Failure (TIME-CHF) randomized trial. Eur J Heart Fail. 2013;15:699–707.
    1. Zuccalà G, Onder G, Marzetti E, et al. For the GIFA study group use of angiotensin-converting enzyme inhibitors and variations in cognitive performance among patients with heart failure. Eur Heart J. 2005;26:226–233.
    1. Laudisio A, Marzetti E, Pagano F, et al. Digoxin and cognitive performance in patients with heart failure: a color, pharmacoepidemiological survey. Drugs Aging. 2009;26:103–112.
    1. Petrucci RJ, Truesdell KC, Carter A, et al. Cognitive dysfunction in advanced heart failure and prospective cardiac assist device patients. Ann Thorac Surg. 2006;81:1738–1744.
    1. Kozdag G, Işeri P, Gökçe G, et al. Treatment with enhanced external counterpulsation improve cognitive functions in chronic heart failure patients. Arch Turk Soc Cardiol. 2013;41:418–428.
    1. Proietti R, Manzoni GM, Cravello L, et al. Can cardiac resynchronization therapy improve cognitive function? A systematic review. Pacing Clin Electrophysiol. 2014;37:520–530.
    1. Feola M, Vallauri P, Salvatico L, et al. Neuropsychological impact of implantable cardioverter defibrillator in congestive heart failure patients. Int J Cardiol. 2013;166:275–276.
    1. Alosco ML, Spitznagel MB, Cohen R, et al. Decreased physical activity predicts cognitive dysfunction and reduced cerebral blood flow in heart failure. J Neurol Sci. 2014;339:169–175.
    1. Tanne D, Freimark D, Poreh A, et al. Cognitive functions in severe congestive heart failure before and after an exercise training program. Int J Cardiol. 2005;103:145–149.
    1. Karlsson MR, Edner M, Henriksson P, et al. A nurse-based management program in heart failure patients affects females and persons with cognitive dysfunction most. Patient Educ Couns. 2005;58:146–153.
    1. Zavertnik JE. Self-care in older adults with heart failure: an integrative review. Clin Nurse Spec. 2014;28:19–32.
    1. McLennan SN, Pearson SA, Cameron J, et al. Prognostic importance of cognitive impairment in chronic heart failure patients: does specialist management make a difference? Eur J Heart Fail. 2006;8:494–451.
    1. Ekman I, Fagerberg B, Skoog I. The clinical implications of cognitive impairment in elderly patients with chronic heart failure. J Cardiovasc Nurs. 2001;16:47–55.

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