Key Points
- To review and critique literature on the prevalence, types, severity, associated clinical factors, and potential pathophysiology of cognitive impairment in patients with heart failure.
- Narrative literature review evaluating studies examining cognitive function, clinical variables, and underlying mechanisms in chronic heart failure populations.
- Assessment of methodological limitations across published studies, including sample representativeness, matched controls, and longitudinal designs.
- Cognitive impairment prevalence ranges from 30% to 80% in heart failure patients, with memory and attention deficits occurring most frequently, followed by slowed motor response times and problem-solving difficulties.
- Most impairments are mild, though up to 25% of patients present with moderate to severe deficits; relationship with left ventricular ejection fraction is inconsistent and potentially nonlinear.
- Underlying pathophysiology is linked to cerebral hypoperfusion, cerebral infarction, or a combination of both mechanisms.
Structured PICO
PPopulationPatients with chronic heart failure (HF)
Cognitive impairment is highly prevalent in heart failure patients, primarily affecting memory and attention, highlighting the need for further research on its mechanisms and impact on self-management.
Limitations
- small or nonrepresentative samples
- few matched control studies
- lack of longitudinal data