Journal of Neurology

, Volume 250, Issue 12, pp 1456–1463

Cognitive impairment: a key feature of congestive heart failure in the elderly

Authors

    • Dept. of Psychology2nd University of Naples
    • Salvatore Maugeri Foundation, Institute of Care and Scientific ResearchRehabilitation Institute of Telese
  • Raffaele Antonelli Incalzi
    • Institute of Internal Medicine, Chair of Geriatry, ”Policlinico Gemelli”School of Medicine
  • Domenico Acanfora
    • Salvatore Maugeri Foundation, Institute of Care and Scientific ResearchRehabilitation Institute of Telese
  • Costantino Picone
    • Salvatore Maugeri Foundation, Institute of Care and Scientific ResearchRehabilitation Institute of Telese
  • Patrizia Mecocci
    • Chair of GeriatrySchool of Medicine
  • Franco Rengo
    • Salvatore Maugeri Foundation, Institute of Care and Scientific ResearchRehabilitation Institute of Telese
    • Institute of Internal Medicine, Cardiology and Cardiovascular Surgery, Chair of Geriatry “Federico II”University School of Medicine
  • the CHF Italian Study Investigators
ORIGINAL COMMUNICATION

DOI: 10.1007/s00415-003-0249-3

Cite this article as:
Trojano, L., Antonelli Incalzi, R., Acanfora, D. et al. J Neurol (2003) 250: 1456. doi:10.1007/s00415-003-0249-3

Abstract.

Congestive heart failure (CHF) has been proposed as a possible cause of cognitive dysfunction but only a few studies have directly assessed cognitive performance in CHF. The aim of the present study was to compare the cognitive patterns of patients with CHF and patients having cardiovascular diseases uncomplicated by CHF (no-CHF group). In a multicenter observational casecontrol study, we studied 149 hospitalized elderly CHF patients in the New York Heart Association (NYHA) class II (CHFm, m: moderate), 159 CHF patients in NYHA class III–IV (CHFs, s: severe), and 207 no-CHF patients. Patients underwent a multidimensional assessment and neuropsychological tests for the following cognitive domains: attention, visual-spatial intelligence, verbal attainment, verbal and visuo-spatial memory. Neuropsychological performances of groups were compared by multivariate analysis. Correlates of an abnormal performance on at least three neuropsychological tests were assessed by logistic regression analysis. CHFs performed worse than no-CHF patients on 4 of the 7 neuropsychological measures, the largest difference being in tests of attention and verbal learning (p < 0.001). Prevalence of abnormal performance on at least 3 tests was 57.9 % in CHFs, 43% in CHFm and 34.3 % in no-CHF groups (chi square = 17.3, p < 0.0001). The following qualified as independent correlates of the outcome at logistic regression analysis: CHFs group membership (Odds Ratio—OR = 2.56, 95% Confidence Interval—CI = 1.49–4.40), depression (OR = 2.37, 95% CI = 1.54–3.66), hypertension (OR = 1.88, 95% CI = 1.18–2.99). Our results demonstrate that cognitive impairment is common among CHF patients and seems to be causally related to CHF severity, depression and hypertension. The cognitive dysfunction also characterizes a relevant fraction of patients with cardiovascular diseases uncomplicated by CHF.

Key words

cognitive impairmentcongestive heart failureaging

Copyright information

© Steinkopff Verlag 2003