September 11, 2026Circulation Heart Failure
Heart Failure and Neurocognitive Disorders: A Narrative Review
Key result
HF-related neurocognitive disorders demand multidisciplinary care and targeted interventions to address interconnected pathways.
Why the study?
Neurocognitive disorders in heart failure are common yet underrecognized, impairing self-care and outcomes, while timely detection, prevention, nonpharmacological approaches, and mental health integration remain limited.
Key Points
- To review the mechanisms connecting heart failure to neurocognitive impairment and highlight practical multidisciplinary strategies for clinical care.
- Synthesized literature on heart failure-associated cognitive conditions, including mild cognitive impairment, dementia, and delirium.
- Analyzed underlying hemodynamic, vascular, and inflammatory pathways alongside pharmacological and nonpharmacological treatment models.
- Identified cerebral hypoperfusion, microvascular and endothelial dysfunction, thromboembolic injury, and neuroendocrine-inflammatory activation as primary interconnected mechanisms.
- Highlighted targeted nonpharmacological interventions, such as treatment plan simplification, active caregiver engagement, and cross-specialty clinical referrals, to improve self-care and clinical outcomes.
Structured PICO
P
Population
Patients with heart failure and neurocognitive disorders (including mild cognitive impairment, dementia, and delirium)
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Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Cognitive impairment is not the exception; it's the norm for our patients with heart failure. We as clinicians must invest the extra effort to identify it, and then adjust management accordingly.”
JCJames C. FangPresident, Heart Failure Society of America
“Thanks to the work done by the co-authors of this HFSA scientific statement, cognitive impairment has been highlighted as a big part of the overall holistic care for patients living with heart failure. Increasing our attention to this important co-morbidity will ensure our patients receive comprehensive care.”
Implication
Highlights the importance of recognizing and managing neurocognitive disorders in heart failure patients through multidisciplinary approaches and targeted nonpharmacological interventions.
Abstract
Neurocognitive disorders-including mild cognitive impairment, dementia, and delirium-are common yet often underrecognized in heart failure, impairing self-care and outcomes. These heart failure-related neurocognitive disorders pose a significant public health challenge due to high morbidity and mortality. Despite recent advances, timely detection, prevention, and intervention remain difficult. Most research focuses on pharmacological treatments, with limited attention to nonpharmacological approaches and mental health integration in heart failure care teams. Progress requires collaboration among internal medicine, surgery, nursing, and psychology. This review highlights interconnected pathways-cerebral hypoperfusion, microvascular and endothelial dysfunction, thromboembolic injury, and neuroendocrine-inflammatory activation-and discusses targeted interventions like simplified treatment plans, caregiver involvement, and multidisciplinary referrals.
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Cite This Study
Lin et al. (2026) conducted a review in Heart failure and neurocognitive disorders. Heart failure-related neurocognitive disorders pose a significant public health challenge, requiring multidisciplinary collaboration and targeted interventions to address interconnected pathways.