Cognitive impairment in young and middle‐aged patients with acute heart failure

Abstract Aims This study aimed to investigate the prevalence, risk factors and prognostic implications of cognitive impairment in young and middle‐aged patients with acute heart failure (HF). Methods In a prospective cohort of patients with acute HF, we assessed cognitive function by the Mini‐Cog, predictors of the cognitive impairment and its associations with 30 day and 1 year cardiovascular death or HF rehospitalization among young and middle‐aged patients (<65 years old). Results Among 1958 young and middle‐aged patients, the prevalence of cognitive impairment was 19.6%. Predictors of cognitive impairment included older age, females, lower education levels and prior strokes. Compared with patients having normal cognitive function, cognitive impairment was associated with a higher risk of 30 day cardiovascular death or HF rehospitalization hazard ratio (HR), 1.52, 95% confidence interval (CI), 1.07–2.17, P = 0.02, but not for 1 year cardiovascular death or HF rehospitalization (HR, 1.06, 95% CI, 0.87–1.30, P = 0.55). Conclusions Cognitive impairment is present in a notable proportion of young and middle‐aged patients with acute HF and is associated with an increased risk of short‐term adverse outcomes. Strategies for screening and intervention for cognitive impairment at a younger age are necessary, particularly for those at high risk.