title: Cognitive deficits in chronic heart failure.
abstract: BACKGROUND
  Patients with heart failure (HF) have been found to have cognitive deficits, but it remains unclear whether these deficits are associated with HF or with aging or comorbid conditions common in HF.
  
  
  OBJECTIVE
  : The purpose of this study was (a) to determine the types, the frequency, and the severity of cognitive deficits among patients with chronic HF compared with age- and education-matched healthy participants and participants with major medical conditions other than HF, and (b) to evaluate the relationships between HF severity, age, and comorbidities and cognitive deficits.
  
  
  METHODS
  A sample of 414 participants completed the study (249 HF patients, 63 healthy and 102 medical participants). The HF patients completed measures of HF severity, comorbidity (multiple comorbidity, depressive symptoms), and neuropsychological functioning. Blood pressure and oxygen saturation were assessed at interview; clinical variables were abstracted from records. Participants in the comparison groups completed the same measures as the HF patients except those specific to HF.
  
  
  RESULTS
  Compared with the healthy and medical participants, HF patients had poorer memory, psychomotor speed, and executive function. Significantly more HF patients (24%) had deficits in three or more domains. Higher (worse) HF severity was associated with more cognitive deficits; HF severity interacted with age to explain deficits in executive function. Surprisingly, men with HF had poorer memory, psychomotor speed, and visuospatial recall ability than women. Multiple comorbidity, hypertension, depressive symptoms, and medications were not associated with cognitive deficits in this sample.
  
  
  CONCLUSIONS
  HF results in losses in memory, psychomotor speed, and executive function in almost one fourth of patients. Patients with more severe HF are at risk for cognitive deficits. Older patients with more severe HF may have more problems in executive function, and men with HF may be at increased risk for cognitive deficits. Studies are urgently needed to identify the mechanisms for the cognitive deficits in HF and to test innovative interventions to prevent cognitive loss and decline.
authors.affiliation: School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA. spressle@umich.edu
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Pressler
authors.forename: Usha
authors.initials: U
authors.lastname: Subramanian
authors.forename: David
authors.initials: D
authors.lastname: Kareken
authors.forename: Susan M
authors.initials: SM
authors.lastname: Perkins
authors.forename: Irmina
authors.initials: I
authors.lastname: Gradus-Pizlo
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Sauvé
authors.forename: Yan
authors.initials: Y
authors.lastname: Ding
authors.forename: JinShil
authors.initials: J
authors.lastname: Kim
authors.forename: Rebecca
authors.initials: R
authors.lastname: Sloan
authors.forename: Heather
authors.initials: H
authors.lastname: Jaynes
authors.forename: Rose Mary
authors.initials: RM
authors.lastname: Shaw
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000517:prevention & control / Q000523:psychology*; D006801:Humans; D008016:Life Change Events; D008297:Male; D008569:Memory Disorders; D008875:Middle Aged; D015146:Midwestern United States; D011788:Quality of Life / Q000523:psychology; D012648:Self Care / Q000379:methods / Q000523:psychology*; D012649:Self Concept; D012647:Self-Assessment; D011795:Surveys and Questionnaires