Risk Factors of Cognitive Impairment on Patients With Heart Failure

Friday, 20 July 2018

Sun Hyoung Bae, PhD
College of Nursing·Nursing Research Institute, Ajou University, suwon, Korea, Republic of (South)
Jin-Hee Park, PhD, RN
College of Nursing, Ajou University, Suwon, Korea, Republic of (South)

PURPOSE: A considerable number of patients suffered from mild cognitive impairment (MCI), but until now there has been insufficient evidences for understanding of mechanisms and risk factor of MCI. This pilot study was conducted to explore the prevalence and risk factors of MCI which impacts on heart failure patients' self-care and quality of life.

METHODS: In this cross-sectional study, 94 patients with heart failure were participated from one Medical hospital in Korea. Participants completed neuropsychological tests and structured questionnaire (consisting of beck depression inventory, beck anxiety inventory, cognitive failures questionnaire and demographics. Raw scores from neuropsychological tests were transformed to Z-score using existing normative data correcting for age, gender, and education. In this study, complex MCI were defined if two more domains were impaired. Logistic regression was used to analyzing the risk factors for MCI in heart failure patients.

RESULTS: Mean age of participants were 67.1 years old. Of the patients, 68 were male and 45 were diagnosed as ejection fraction redacted heart failure. Patients with heart failure scored lower than expected age and education adjusted norms in the domains of memory (z = -3.02, SD = 1.15), and executive function (z = -1.42, SD = 2.21). Meanwhile, the patients’ attention domain score was similar with norm based score (z = 0.01, SD = 1.11). 57.4% of heart failure patients exhibited complex cognitive impairment. According to the logistic regression, low-income (odd ratio [OR]=12.11, p=.035), low level of activity (OR=1.03, p=.044), and depressed (OR=7.44, p=.007) patients were at high risk for cognitive impairment.

CONCLUSION: These results suggest that patients with heart failure may be associated with mild cognitive impairments. Screening for low-income, low level of activity is important and necessary to identify patient who are at risk of cognitive impairment. Further studies are needed to develop and evaluate nursing interventions for prevention cognitive impairments and enhance self-care and quality of life through supporting cognitive function.