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J Card Fail. 2019 Feb;25(2):130-136. doi: 10.1016/j.cardfail.2018.12.006. Epub 2018 Dec 22.

The Prevalence of Cognitive Impairment Among Adults With Incident Heart Failure: The "Reasons for Geographic and Racial Differences in Stroke" (REGARDS) Study.

Author information

1
Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York. Electronic address: mrs9012@med.cornell.edu.
2
Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York.
3
Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York.
4
Dornsife School of Public Health at Drexel University, Philadelphia, Pennsylvania.
5
Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
6
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana.
7
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama.
8
Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York; Division of Cardiology, Department of Medicine, Weill Cornell Medical College, New York, New York.
9
Department of Neurology, Columbia University Medical Center, New York, New York.
10
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan.

Abstract

BACKGROUND:

Cognitive impairment (CI) is estimated to be present in 25%-80% of heart failure (HF) patients, but its prevalence at diagnosis is unclear. To improve our understanding of cognition in HF, we determined the prevalence of CI among adults with incident HF in the REGARDS study.

METHODS AND RESULTS:

REGARDS is a longitudinal cohort study of adults ≥45 years of age recruited in the years 2003-2007. Incident HF was expert adjudicated. Cognitive function was assessed with the Six-Item Screener. The prevalence of CI among those with incident HF was compared with the prevalence of CI among an age-, sex-, and race-matched cohort without HF. The 436 participants with incident HF had a mean age of 70.3 years (SD 8.9), 47% were female, and 39% were black. Old age, black race, female sex, less education, and anticoagulation use were associated with CI. The prevalence of CI among participants with incident HF (14.9% [95% CI 11.7%-18.6%]) was similar to the non-HF matched cohort (13.4% [11.6%-15.4%]; P < .43).

CONCLUSIONS:

A total of 14.9% of the adults with incident HF had CI, suggesting that the majority of cognitive decline occurs after HF diagnosis. Increased awareness of CI among newly diagnosed patients and ways to mitigate it in the context of HF management are warranted.

KEYWORDS:

Heart failure; cognition; cohort study; hospitalization; prevalence

PMID:
30582968
PMCID:
PMC6377841
[Available on 2020-02-01]
DOI:
10.1016/j.cardfail.2018.12.006

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