Abstract 2718: Cognitive Function is Poorer in Heart Failure

Abstract

Background: Heart failure (HF) patients have been found to have cognitive deficits but studies have been limited by small samples and lack of comparison groups. Objective: To determine the types, frequency, and severity of cognitive deficits among patients (pts) with chronic HF compared to age- and education-matched healthy (HC) participants and participants with major medical conditions but not HF (MC). Methods: In this comparative study, face-to-face interviews were completed by 414 participants (249 HF pts, 63 HC, 102 MC) to assess function in cognitive domains of language, working memory, memory (verbal learning total and delayed recall), psychomotor speed, and executive function. Characteristics of HF pts were: mean age 62.9 yrs; 63% men; mean education 12.9 yrs; mean LVEF 28%; NYHA I-15%; II-34%; III-39%; IV-12%). HC and MC groups were matched on education and premorbid intellect, but HC were younger than HF and MC groups. Comparisons among the 3 groups were made using ANCOVA adjusting for intellect, age, and education. Family members of all participants were interviewed separately to validate cognitive deficits. Results: No differences were found among HF, HC and MC participants in language or working memory. In verbal learning total recall, HF pts had poorer scores than HC and MC participants (p<.0001). In delayed recall, HF pts had poorer scores than MC participants (p=.0152). In psychomotor speed, HF pts had poorer scores than HC and MC participants (p<.0001) on 1 test and poorer scores than MC (p=.0177) on the 2 nd . In executive function (verbal fluency and mental flexibility), HF pts had poorer scores than MC participants (p = .0022; p = .0428). Family member reported more difficulty in memory among HF pts (p< .0001) than HC ((p< .0001) and more negative behavior changes than HC (p=.0025) and MC participants (p=.0291). Conclusions: This carefully characterized sample of HF pts had poorer cognitive function than HC and MC participants. Domains most affected were memory, psychomotor speed processing, and executive function. Studies are needed to 1) evaluate the trajectory of cognitive function across the trajectory of HF; and 2) test novel interventions to improve cognitive function in HF.