title: Cognitive status in patients hospitalized with acute decompensated heart failure.
abstract: BACKGROUND
  Cognitive impairment is highly prevalent in patients with heart failure and is associated with adverse outcomes. However, whether specific cognitive abilities (eg, memory vs executive function) are impaired in heart failure has not been fully examined. We investigated the prevalence of impairment in 3 cognitive domains in patients hospitalized with acute decompensated heart failure (ADHF) and the associations of impairment with demographic and clinical characteristics.
  
  
  METHODS
  The sample included 744 patients hospitalized with ADHF (mean age 72 years, 46% female) at 5 medical centers. Impairment was assessed in 3 cognitive domains (memory, processing speed, executive function) using standardized measures. Demographic and clinical characteristics were obtained from a structured interview and medical record review.
  
  
  RESULTS
  A total of 593 (80%) of 744 patients were impaired in at least 1 cognitive domain; 32%, 31%, and 17% of patients were impaired in 1, 2, or all 3 cognitive domains, respectively. Patients impaired in more than 1 cognitive domain were significantly older, had less formal education, and had more noncardiac comorbidities (all P values < .05). In multivariable adjusted analyses, patients with older age and lower education had higher odds of impairment in 2 or more cognitive domains. Depressed patients had twice the odds of being impaired in all 3 cognitive domains (odds ratio 1.98, 95% CI 1.08-3.64).
  
  
  CONCLUSIONS
  Impairments in executive function, processing speed, and memory are common among patients hospitalized for ADHF. Recognition of these prevalent cognitive deficits is critical for the clinical management of these high-risk patients.
authors.affiliation: Department of Medicine, University of Massachusetts Medical School (UMMS), Worcester, MA.
authors.forename: Seth N
authors.initials: SN
authors.lastname: Levin
authors.affiliation: Department of Quantitative Health Sciences, UMMS, Worcester, MA; Meyers Primary Care Institute, UMMS, Worcester, MA.
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Hajduk
authors.affiliation: Department of Medicine, University of Massachusetts Medical School (UMMS), Worcester, MA.
authors.forename: David D
authors.initials: DD
authors.lastname: McManus
authors.affiliation: Department of Emergency Medicine, UMMS, Worcester MA.
authors.forename: Chad E
authors.initials: CE
authors.lastname: Darling
authors.affiliation: Department of Medicine, University of Massachusetts Medical School (UMMS), Worcester, MA; Meyers Primary Care Institute, UMMS, Worcester, MA.
authors.forename: Jerry H
authors.initials: JH
authors.lastname: Gurwitz
authors.affiliation: Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Spencer
authors.affiliation: Department of Quantitative Health Sciences, UMMS, Worcester, MA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Goldberg
authors.affiliation: Department of Medicine, University of Massachusetts Medical School (UMMS), Worcester, MA; Department of Quantitative Health Sciences, UMMS, Worcester, MA; Meyers Primary Care Institute, UMMS, Worcester, MA. Electronic address: Jane.Saczynski@umassmed.edu.
authors.forename: Jane S
authors.initials: JS
authors.lastname: Saczynski
mesh_terms: D000208:Acute Disease; D000368:Aged; D002170:Canada / Q000453:epidemiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D003710:Demography; D056344:Executive Function; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006333:Heart Failure / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008501:Medical Records, Problem-Oriented; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D009483:Neuropsychological Tests; D015995:Prevalence; D011597:Psychomotor Performance; D012307:Risk Factors