What is your patient's cognitive profile? Three distinct subgroups of cognitive function in persons with heart failure

Abstract

Purpose: The aim of this study was to determine whether patients with heart failure (HF) have distinct profiles of cognitive impairment.

Background: Cognitive impairment is common in HF. Recent work found three cognitive profiles in HF patients-(1) intact, (2) impaired, and (3) memory-impaired. We examined the reproducibility of these profiles and clarified mechanisms.

Methods: HF patients (68.6 ± 9.7 years; N=329) completed neuropsychological testing. Composite scores were created for cognitive domains and used to identify clusters via agglomerative-hierarchical cluster analysis.

Results: A 3-cluster solution emerged. Cluster 1 (n=109) had intact cognition. Cluster 2 (n=123) was impaired across all domains. Cluster 3 (n=97) had impaired memory only. Clusters differed in age, race, education, SES, IQ, BMI, and diabetes (ps ≤ .026) but not in mood, anxiety, cardiovascular, or pulmonary disease (ps ≥ .118).

Conclusions: We replicated three distinct patterns of cognitive function in persons with HF. These profiles may help providers offer tailored care to patients with different cognitive and clinical needs.

Keywords: Cardiovascular disease; Cluster analysis; Cognitive profiles; Neuropsychological performance; Older adults.

Conflict of interest statement

Conflict of Interest: None.

Copyright © 2014 Elsevier Inc. All rights reserved.

Figures

Figure 1

Dendrogram Produced by Hierarchical Cluster Analysis. Note. Dendrogram created using SAS 9.3.

Figure 2

Composite Performance on Cognitive Domains in Patients with Heart Failure (N = 329). Note. Composites scores are average of z-scores (M = 0, SD = 1)