title: Association of low ejection fraction with impaired verbal memory in older patients with heart failure.
abstract: BACKGROUND
  Cognitive dysfunction has a major role in health outcomes for cardiac patients. The association of cognitive dysfunction with heart failure is well established, but the cardiac variables that contribute to cognition are not well understood.
  
  
  OBJECTIVE
  To investigate the relationships among age, memory, and left ventricular ejection fraction (EF) in patients with heart failure.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  A total of 207 patients with heart failure underwent neuropsychological assessment of memory on standardized tests.
  
  
  METHODS
  Patients were grouped by age quartiles, and memory function was compared in those with an EF below 30% vs those with an EF of 30% or higher.
  
  
  RESULTS
  Demographic, cognitive, and medical variables having a significant association with a memory composite score were identified in a univariate linear regression analysis. In a multivariate linear model that adjusted for significant covariates, there was a significant interaction between age and EF for memory function. Patients younger than 63 years maintained stable memory function across EF levels, but patients 63 years or older showed a significant decline in memory performance when EF dropped below 30% (P < .02). Post hoc multivariate analysis showed that verbal delayed recall and recognition were the components of memory most affected by low EF.
  
  
  CONCLUSIONS
  The effect of EF on memory differs by age such that older patients with lower EFs have significantly reduced verbal memory function.
authors.affiliation: Department of Neurology, St Luke's-Roosevelt Hospital Center, New York, NY 10019, USA. jfesta@chpnet.org
authors.forename: Joanne R
authors.initials: JR
authors.lastname: Festa
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Jia
authors.forename: Ken
authors.initials: K
authors.lastname: Cheung
authors.forename: Adrian
authors.initials: A
authors.lastname: Marchidann
authors.forename: Michael
authors.initials: M
authors.lastname: Schmidt
authors.forename: Peter A
authors.initials: PA
authors.lastname: Shapiro
authors.forename: Donna M
authors.initials: DM
authors.lastname: Mancini
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Naka
authors.forename: Mario
authors.initials: M
authors.lastname: Deng
authors.forename: Emily R
authors.initials: ER
authors.lastname: Lantz
authors.forename: Randolph S
authors.initials: RS
authors.lastname: Marshall
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Lazar
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology*; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000503:physiopathology*; D008875:Middle Aged; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology*; D055815:Young Adult