Clinical research studyCorrelates of cognitive impairment among patients with heart failure: Results of a multicenter survey
Section snippets
Study methods
We analyzed the database of the Gruppo Italiano di Farmacoepidemiologia nell’Anziano (GIFA), a large collaborative hospital study. This study has been approved by the Bioethical Committee at the Catholic University of the Sacred Heart in Rome. The methods of the GIFA have been described in detail elsewhere.17 Briefly, all 32 243 patients admitted to 81 clinical centers (either geriatric or internal medicine hospital wards) throughout Italy in several surveys were enrolled on admission and
Prevalent cognitive impairment according to diagnosis of heart failure
Among the 16 913 participants in the GIFA database who were suitable for analysis during the years of interest, cognitive dysfunction was detected in 35% (526/1511) of participants with diagnosis of heart failure and in 29% (3448/11 790) of the remaining subjects (P <0.0001).
Correlates of cognitive impairment among participants with heart failure
The main characteristics, according to presence of cognitive impairment, of the 1511 participants with a verified diagnosis of heart failure are depicted in Table 1.
In the initial age- and sex-adjusted logistic regression
Discussion
Despite advances in the care of patients with heart failure, uncertainty remains about effective management of elderly subjects with comorbidities.14 In fact, heart failure in older populations is still associated with impressive hospitalization and mortality rates, as well as prevalent functional disability.12, 13 Noncardiac comorbidity has been proven a major determinant of such persistently poor outcomes of treatment, and it has been hypothesized that comprehensive approaches might reduce
References (42)
- et al.
Confirmation of a heart failure epidemicfindings from the Resource Utilization Among Congestive Heart Failure (REACH) study
J Am Coll Cardiol
(2002) - et al.
The effects of cognitive impairment on mortality among hospitalized patients with heart failure
Am J Med
(2003) - et al.
Noncardiac comorbidity increases preventable hospitalizations and mortality among Medicare beneficiaries with chronic heart failure
J Am Coll Cardiol
(2003) - et al.
Pharmacosurveillance in hospitalized patients in Italy. Study design of the ’Gruppo Italiano di Farmacovigilanza nell’Anziano’ (GIFA)
Pharmacol Res
(1999) - et al.
Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases
J Clin Epidemiol
(1992) - et al.
Delivering the cumulative benefits of triple therapy to improve outcomes in heart failuretoo many cooks will spoil the broth
J Am Coll Cardiol
(2003) - et al.
Reversible dementias
Med Clin North Am
(1993) - et al.
Reverse epidemiology of conventional cardiovascular risk factors in patients with chronic heart failure
J Am Coll Cardiol
(2004) - et al.
Association between polymorphism in regulatory region of gene encoding tumour necrosis factor alpha and risk of Alzheimer’s disease and vascular dementiaa case-control study
Lancet
(2001) - et al.
The mind of a failing hearta systematic review of the association between congestive heart failure and cognitive functioning
Intern Med J
(2001)
Brain hypoperfusiona critical factor in vascular dementia
Neurol Res
Left ventricular dysfunctiona clue to cognitive impairment in older patients with heart failure
J Neurol Neurosurg Psychiatry
Hypotension and cognitive impairmentselective association in patients with heart failure
Neurology
Prognostic significance of cerebral metabolic abnormalities in patients with congestive heart failure
Circulation
Cerebrovascular reactivity is impaired in patients with cardiac failure
Eur Heart J
Cardiogenic dementia
Lancet
Cognitive impairment in congestive heart failure? Embolism vs hypoperfusion
Neurology
Cognitive dysfunction as a major determinant of disability in patients with heart failureresults from a multicentre survey
J Neurol Neurosurg Psychiatry
Progress in heart failure management? Lessons from the real world
Circulation
Heart failure in the 21st centurya cardiogeriatric syndrome
J Gerontol A Biol Sci Med Sci
Improvement of cerebral blood flow and cognitive function following pacemaker implantation in patients with bradycardia
Gerontology
Cited by (160)
Cognitive Impairment in Heart Failure: A Heart Failure Society of America Scientific Statement
2024, Journal of Cardiac FailureRisk evaluation of cognitive impairment in patients with heart failure: A call for action
2022, IJC Heart and VasculatureCurrent Emergency Department Disposition of Patients With Acute Heart Failure: An Opportunity for Improvement
2022, Journal of Cardiac FailurePrevalence and incidence of cognitive impairment and dementia in heart failure – A systematic review, meta-analysis and meta-regression
2022, Hellenic Journal of CardiologyHeart and brain interactions in heart failure: Cognition, depression, anxiety, and related outcomes
2021, Revista Portuguesa de CardiologiaSex and race differences in the association of albumin with cognitive function in older adults
2024, Brain and Behavior
The GIFA study was partially supported by a grant from the National Research Council (n.94000402). The work of Dr. Cesari was supported by the Wake Forest University Claude D. Pepper Older Americans Independence Center (NIA grant P30-AG-021332-03).