Mild cognitive impairment, screening, and patient perceptions in heart failure patients.
OBJECTIVE
Cognitive impairments are prevalent in heart failure (HF) patients, worsening outcomes but often undetected.The aim of this study was to screen HF outpatients for mild cognitive impairment (MCI), determine the areas of cognition affected, patient awareness of cognitive change, and associated factors.


RESULTS
HF patients (n = 128) newly registered for the Management of Cardiac Function program, free from neurocognitive disorder, and with sufficient visual acuity were assessed with the use of the Montreal Cognitive Assessment tool (MoCA). MCI was classified as MoCA score ≤22. The sample was elderly (mean, 80.65 years; SD, 11.52). Mean MoCA score was 24.58 (SD 3.45), 22% were classified as impaired, 45% had noticed a change in cognition, and 15% reported that they were affected in their daily lives. Patients noticing this impact had lower MoCA scores (22.74, SD 3.0) than those who did not (25.17, SD 2.96; P ≤ .02). Most impairments occurred for delayed recall, visuospatial/executive function, and abstraction. The odds of impairment increased by the presence of ischemic heart disease (odds ratio, 4.18; 95% confidence interval, 1.15-15.69).


CONCLUSIONS
In HF outpatients without a dementia diagnosis, MCI is prevalent. Screening for MCI and incorporation of compensatory strategies are essential.
Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, Australia. Electronic address: robyn.gallagher@uts.edu.au.
Robyn
R
Gallagher
Anne
A
Sullivan
Rhonda
R
Burke
Susan
S
Hales
Geraldine
G
Gillies
Jan
J
Cameron
Bernard
B
Saliba
Geoffrey
G
Tofler
D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010358:Patient Participation / Q000379:methods / Q000523:psychology*; D010865:Pilot Projects; D057566:Self Report
Cognitive impairment; awareness; comorbidity; heart failure; screening