Prevalence of Cognitive Impairment in Patients With Heart Failure

Background And Purpose: Heart failure (HF) is a global health problem with increasing prevalence. Cognitive impairment (CI) is a frequent comorbidity, affecting ~41% of HF patients worldwide and 44% in South Asia. CI contributes to poor self-care, frequent hospitalizations, reduced quality of life, and higher mortality. Despite this burden, data from India remain scarce. Methods: This cross-sectional study was conducted over 24 months at Bharati Hospital and Research Centre, Pune. Adults (≥18 years) with Stage C or D HF, as per ACCF/AHA criteria, were included. Patients with dementia, psychiatric illness, epilepsy, or recent CNS infection were excluded. After clinical stabilization, 100 patients underwent cognitive assessment using the Rapid Cognitive Screen (RCS), which evaluates recall, clock drawing, and story recall. Clinical and echocardiographic data were also collected. Results: The mean age was 55.7 ± 14.3 years, and 72% were male. CI was present in 50% of the cohort. Female patients had a significantly higher prevalence of CI than males (68% vs. 43%, p = 0.03). Recall impairment was universal among patients with CI, while clock drawing impairment showed the strongest statistical association (p = 0.001). Story recall was also significantly associated (p = 0.047). CI prevalence varied across ejection fraction (EF) groups-47.7% in preserved EF, 45.5% in mildly reduced EF, and 55.9% in reduced EFbut was not statistically significant (p = 0.69). Conclusions: Cognitive impairment is highly prevalent among Indian HF patients, with women disproportionately affected. Routine cognitive screening should be integrated into HF care to improve outcomes.