Cognitive Impairment Amongst Older Adults With Heart Failure: A Global Pooled Meta-Analysis.

BACKGROUND: Cognitive impairment (CI) is increasingly recognised as a common comorbidity among older adults with heart failure (HF) and is associated with reduced self-care, poor medication adherence, and worse clinical outcomes. Reported prevalence varies widely across studies due to differences in populations, cognitive assessment tools, and geographic regions. This systematic review and meta-analysis aimed to estimate the global prevalence of CI among older adults with HF and examine sources of variability across studies. METHODS: statistic. Prespecified subgroup analyses were performed by age, geographic region, and study design. Sensitivity analyses were conducted using a leave-one-out approach. RESULTS: =98.6%). CI prevalence was highest in the United States (50.9%), followed by Asia (46.5%) and Europe (35.0%). Patients aged ≥80 years demonstrated higher prevalence (48.6%) compared with those aged 70-79 years (38.9%). Prospective studies reported higher prevalence than retrospective designs. Sensitivity analyses confirmed the robustness of the findings. CONCLUSIONS: Approximately 44% of older adults with HF have CI, representing a substantial global burden. These findings support routine cognitive screening in older HF populations to guide clinical decision-making and improve outcomes. Future studies should evaluate longitudinal cognitive trajectories and interventions aimed at improving both cognitive and cardiovascular outcomes.