Geriatrics and Gerontology special sectionClinical research studyCognitive Impairment in Older Adults with Heart Failure: Prevalence, Documentation, and Impact on Outcomes
Section snippets
Study Design and Participants
We performed a prospective cohort study of older adults hospitalized for heart failure at 2 Connecticut Hospitals (Yale-New Haven Hospital and Hospital of Saint Raphael). Participants were enrolled in the Comorbidity in Older Patients with heart failure (COPing with Heart Failure) study, which recruited patients aged 65 years or more who were hospitalized for heart failure between October 31, 2008, and December 22, 2010. The objective of the COPing with Heart Failure study was to assess the
Study Sample
Of the 437 patients approached for enrollment, 48 were excluded because of dependency in activities of daily living, 3 were excluded because of delirium, and 104 declined participation, leaving a total of 282 (64.5%) who consented to participation in the study. There were no significant differences between patients who consented versus those who did not consent (mean age 80.0 vs 80.4 years, P = .87; female 53.2% vs 50.3%, P = .56; nonwhite 18.8% vs 16.4%, P = .62). The baseline clinical
Discussion
In our study of older adults hospitalized for heart failure, we found that cognitive impairment was common (present in 47% of the study sample) and yet documented in only a minority of patients. As expected, documentation improved as the severity of cognitive impairment increased, but even among patients with moderate-severe impairment it was documented in less than half of the patients. Although prior studies have demonstrated that cognitive impairment is present in a significant subset of
Conclusions
Cognitive impairment is present in a substantial number of older patients hospitalized for heart failure, yet it is infrequently documented by physicians at the time of hospital discharge. The presence of cognitive impairment and lack of documentation are associated with increased 6-month mortality or readmission. Future studies are needed to determine whether efforts to improve recognition and documentation at the time of inpatient hospitalization may inform individually tailored heart failure
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Cited by (0)
Michael W. Rich, MD, Section Editor
Funding: Dr Dodson is supported by a training grant in Geriatric Clinical Epidemiology from the National Institutes of Health (NIH)/National Institute on Aging (T32 AG019134) and a Clinical Research Loan Repayment award from the NIH/National Heart, Lung, and Blood Institute. Dr Chaudhry is supported by a Beeson Career Development Award from the NIH/National Institute on Aging (K23 AG030986).
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.