Abstract
Background/Aims: Cognitive impairment (CI) is increasingly being recognized as an important clinical issue in the context of providing care to older adults with other prevalent medical conditions, including cardiovascular disease. The purpose of this study was to describe the prevalence of CI among older adults hospitalized with decompensated HF, and examine factors associated with cognitive status.
Methods: Preliminary data from the Observational Study of Heart Failure Delays are currently available from 277 patients (mean age = 76 years; 46% female) who received care in four area hospitals. Patients were interviewed using a 25-minute standardized questionnaire within 72 hours of hospital admission to obtain information regarding occurrence and timing of HF symptoms, care seeking behavior, and general knowledge of HF. Cognitive function in 3 sub-domains was assessed using standardized measures of memory, processing speed, and executive function. Cognitive impairment, defined using established norms, was calculated separately for each sub-domain.
Results: One half of patients (51%, 141 of 277) had impaired processing speed, 42% (117 of 277) had impaired memory, and 65% (180 of 277) had impaired executive function. Approximately one third of patients (32%, 89 of 277) were impaired on only 1 domain, one third (34%, 95 of 277) were impaired in 2 of 3 domains and one fifth (19%, 53 of 277) were impaired on all 3 domains. Only 14% (40 of 277) had no evidence of CI. Patients with a high degree of CI (those impaired in multiple domains) were older, more likely to have less than a high school education, and were more likely to have a history of HF compared to patients with less CI (all p’s <0.01). Patients with a high degree of CI also had significantly lower overall knowledge of the signs, symptoms, and self-management activities associated with HF (p<0.05).
Conclusions: These preliminary data suggest that most patients hospitalized for decompensated HF are cognitively impaired. Cognitively impaired patients with HF may have poorer knowledge of the signs and symptoms associated with an exacerbation of HF as well as poorer knowledge of self-management techniques which may lead to poorer care seeking practices and long-term outcomes.
- Received May 27, 2010.
- Accepted May 27, 2010.
