![[ Visit Client Website ]](images/banner.gif)
Learning Objective 1: understand the magnitude and risk of cognitive deficit in heart failure
Learning Objective 2: understand the need for early cognitive screening in patients with heart failure
Methods: A cross sectional study enrolled ninety community dwelling adults aged 50 and above in stable HF. Participants were administered the MMSE and MoCA, questionnaires to measure co-morbidity, depression, disability, and completed a six-minute walk test. Clinical and demographic data were collected via questionnaire. Cerebral perfusion pressure was measured via transcranial doppler and cardiac index via impedance cardiograph.
Results: Most participants were men (66%), Caucasian (78%), aged 50 to 89 (62 ± 9 years), 80% were in HF stage C, and 77% had ejection fraction <40%. The MoCA identified 54% participants with mild cognitive impairment and 17% with moderate cognitive impairment with a score of (24.86 ± 2.81) compared to 2.2% on the MMSE with a score of (28.96 ± 1.66). The results confirm findings of researchers that the MMSE is not sensitive to identify subtle cognitive changes in HF. Also, the MoCA identified pattern of CD in specific neuropsychological domains: delayed recall 87%, Visuo-spatial 69%, memory 61%, and attention 47%; that validates findings of several researchers. Conclusion: The results indicate that MoCA may be a sensitive screening tool in identifying subtle cognitive changes than MMSE. Early identification of CD may help prevent permanent CD and may improve adherence to self-care. An appropriately designed longitudinal study is warranted to validate MoCA, explore use of clinical cut off score <22 on the MoCA, and other factors that may influence CD in HF.