title: Profile and Determinants of Neurocognitive Dysfunction in a Sample of Adult Nigerians With Heart Failure.
abstract: Heart failure (HF) in Africans is peculiar because subjects are younger than whites and have lower socioeconomic and educational level in addition to the high prevalence of hypertension-related etiology and increased mortality. Whereas cognitive dysfunction have been demonstrated among whites with HF, the prevalence and pattern of cognitive dysfunction among sub-Saharan African patients with HF have not been evaluated against this background.
  
  
  
  The aim of this study is to determine the 1-year prevalence and the factors contributing to cognitive dysfunction in a cohort of Nigerian patients with HF.
  
  
  
  In this cross-sectional case-control study, cognitive performance was evaluated in 111 consecutive individuals (60 HF patients and 51 controls matched for age, gender, and level of education) using the Community Screening Interview for Dementia, Word List Learning Delayed Recall, Boston Naming Test, and Modified Token Test. Other clinical and disease-specific variables were collated and correlated with cognitive performance.
  
  
  
  The mean total Community Screening Interview for Dementia, Word List Learning Delayed Recall, Boston Naming Test, and Modified Token Test scores were significantly lower among HF patients (P = < .001). The prevalence of global cognitive dysfunction was 90.0% in HF and 5.9% among controls (odds ratio, 15.3; 95% confidence interval, 5.08-46.01). Elevated systolic blood pressure, increased comorbidity index, and wide pulse pressure were significantly associated with poorer performance on at least 1 neuropsychological test. Using a multivariate linear regression analysis, pulse pressure retained its significance (P = .029; 95% confidence interval, -0.117 to -0.007) as the most important predictor of cognitive dysfunction in the cohort of HF patients.
  
  
  
  Cognitive dysfunction is prevalent among this sample of Nigerians with HF. Regular cognitive screening is therefore advocated among this high-risk group. Controlling comorbidities as well as blood pressure may improve cognitive performance among patients with HF.
authors.affiliation: Philip Babatunde Adebayo, FWACP Consultant Neurologist, Department of Medicine, Faculty of Clinical Sciences, Ladoke Akintola University of Technology, Osogbo; and Ladoke Akintola University of Technology Teaching Hospital, Ogbomoşo, Nigeria. Adeseye Abiodun Akintunde, FMCP, FWACP Consultant Cardiologist, Department of Medicine, Faculty of Clinical Sciences, Ladoke Akintola University of Technology, Osogbo; and Ladoke Akintola University of Technology Teaching Hospital, Ogbomoşo, Nigeria. Morenike Bosede Audu, MBBS Registrar in Neurology, Ladoke Akintola University of Technology Teaching Hospital, Ogbomoşo, Nigeria. Olugbenga Edward Ayodele, FWACP Professor, Department of Medicine, Faculty of Clinical Sciences, Ladoke Akintola University of Technology, Osogbo; and Ladoke Akintola University of Technology Teaching Hospital, Ogbomoşo, Nigeria. Rufus Olushola Akinyemi, PhD, FMCP Consultant Neurologist, Neurology Division, Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria. Oladimeji George Opadijo, FWACP Professor, Department of Medicine, Faculty of Clinical Sciences, Ladoke Akintola University of Technology, Osogbo; and Ladoke Akintola University of Technology Teaching Hospital, Ogbomoşo, Nigeria.
authors.forename: Philip Babatunde
authors.initials: PB
authors.lastname: Adebayo
authors.forename: Adeseye Abiodun
authors.initials: AA
authors.lastname: Akintunde
authors.forename: Morenike Bosede
authors.initials: MB
authors.lastname: Audu
authors.forename: Olugbenga Edward
authors.initials: OE
authors.lastname: Ayodele
authors.forename: Rufus Olushola
authors.initials: RO
authors.lastname: Akinyemi
authors.forename: Oladimeji George
authors.initials: OG
authors.lastname: Opadijo
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000150:complications*; D003430:Cross-Sectional Studies; D006333:Heart Failure / Q000150:complications / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests