Evidence Summary of Management Strategies for Cognitive Impairment in Patients with Heart Failure

Purpose: Cognitive impairment presents significant challenges for the management and prognosis of patients with heart failure. Previous studies have underscored the importance of evidence-based investigation of cognitive impairment in this population; however, specific management strategies have not yet been clearly identified. This study aims to systematically retrieve, extract, appraise, and synthesize evidence on management strategies for cognitive impairment in patients with heart failure to inform clinical nursing practice. Methods: Guided by the 6S evidence pyramid, we systematically identified evidence on strategies to manage cognitive impairment in patients with heart failure. We included guidelines, clinical decision-making documents, expert consensus statements, and systematic reviews; searches covered database inception to 18 May 2024. Two researchers independently appraised the methodological quality, and evidence was extracted and synthesised thematically. Results: Nine documents were included: one guideline, two clinical decision tools, two expert consensus statements, and four systematic reviews. Evidence was synthesised across four domains-assessment, cognitive training and rehabilitation; dietary and exercise interventions; and multi-stakeholder support management systems-yielding 17 evidence statements. Routine standardized cognitive assessment, structured cognitive rehabilitation, individualized exercise and dietary interventions, and multidisciplinary management models with caregiver involvement may improve cognitive function and enhance self-care and treatment adherence in patients with heart failure. Conclusion: This study synthesizes current evidence on management strategies for cognitive impairment in heart failure and provides a reference for clinical nursing practice and guidance for healthcare teams in developing and implementing related management plans.