Factors Associated With Cognitive Impairment in Heart Failure With Preserved Ejection Fraction.
Kenneth M Faulkner, Victoria Vaughan Dickson, Jason Fletcher and 6 others
PMID 32649377WHAT IT FOUND
People with HFpEF scored worse than people without HF on attention, language, executive function, and global cognition.
Screen HF patients for cognitive and depression symptoms before relying on self-care plans.
Key findings
01Participants with HFpEF scored significantly worse than participants with no HF on tests of attention/processing speed, language/verbal fluency, executive function, and global cognitive function.
02In HFpEF, worse diastolic function remained independently associated with worse memory, attention, and language, with small standardized effects of 0.125 to 0.17.
03Higher cardiac index was independently associated with slower completion of Trail Making Test Part A: a 1-L/m2 increase was associated with 12.3 additional seconds needed to complete it.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The HFpEF group had 205 participants, much smaller than the no-HF group, so HFpEF estimates are less stable. The sample was biased toward healthier participants because visit 5 required a full-day evaluation. Most HFpEF participants had mild diastolic dysfunction and early HFpEF, so results may not apply to advanced HFpEF. Cognition and cardiac function were measured at one time point, so the study cannot show cause or direction. Several cardiac associations were weak, inconsistent, or disappeared after adjustment; the higher cardiac index finding was counterintuitive and may be incidental or affected by attendance bias. Echocardiographic measures had 5% to 10% missing data, handled by imputation. The analysis used a stricter P value threshold, which reduces false positives but may miss smaller associations.
Declared interests
The authors have no conflicts of interest to disclose.
The easy way to misread this
Do not read this as proof that HFpEF causes cognitive impairment or that echocardiographic measures can predict it. The analysis was cross-sectional, the HFpEF group was small and mostly had mild disease, and several associations were weak or disappeared after adjustment.