title: Detecting and Managing Cognitive Impairment to Improve Engagement in Heart Failure Self-Care.
abstract: The purpose of this review was to examine the recent literature on detecting cognitive impairment in patients with heart failure (HF) and the evidence indicating any ramifications of cognitive impairment on patient engagement in HF self-care.
  
  
  
  Mild cognitive impairment (MCI) is common in HF and impacts on patients' engagement in self-care, yet it is frequently not detected. The use of screening tools, even when brief, improves detection of MCI. However, the most sensitive, specific and feasible screening measure to use in practice is yet to be identified. A full neuropsychological assessment is required to determine a diagnosis of cognitive impairment and to identify the specific areas of cognitive deficit. In patients with HF, there appears to be differing clusters of cognitive deficits. Identification of these deficits may help inform the application of specific cognitive training strategies to ameliorating cognitive changes in HF patients and potentially enhance engagement in self-care. Screening for cognitive impairment is crucial in the management of HF patients to ensure that potential self-care deficits are prevented. The optimal screening tool is yet to be identified.
authors.affiliation: Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Level 1/43-51 Kanooka Grove, Clayton, VIC, 3168, Australia. jan.cameron@monash.edu.|Australian Centre for Heart Health, The Royal Melbourne Hospital, PO Box 2137, Parkville, VIC, 3050, Australia. jan.cameron@monash.edu.
authors.forename: Jan
authors.initials: J
authors.lastname: Cameron
authors.affiliation: Charles Perkins Centre, Sydney Nursing School, University of Sydney, Room 2210, Level 2, Building D17, Sydney, NSW, 2006, Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Gallagher
authors.affiliation: Center for Enhancing Quality of Life in Chronic Illness, Indiana University, School of Nursing, 600 Barnhill Drive, NU E409, Indianapolis, IN, 46202, USA.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Pressler
mesh_terms: D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006333:Heart Failure / Q000150:complications / Q000628:therapy*; D006801:Humans; D009483:Neuropsychological Tests; D012648:Self Care
keywords: Cognitive impairment; Cognitive screening; Heart failure; Self-care