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Examination of attention, executive function, and memory as predictors of mortality risk in adults with systolic heart failure.

ABSTRACT: BACKGROUND:The prevalence and impact of cognitive impairment in heart failure is increasingly recognized. Converging evidence points to global cognitive function as predictive of prognosis in adults with heart failure when assessed with screening tools. Additional work is needed to understand which domains of cognitive function are most relevant for prognosis. AIMS:The present study sought to examine associations between domains of cognitive function and mortality risk in adults with heart failure. METHODS:In the present prospective, observational cohort study, global cognitive function, attention, executive function, and memory were assessed by means of a comprehensive neuropsychogical battery in adults with systolic heart failure. Mortality data were obtained from the National Death Index (median follow-up 2.95 years). Relationships among each cognitive domain and mortality were assessed with Cox regression. Covariates included age, sex, heart failure severity, comorbidity and depressive symptoms. RESULTS:Participants were 325 patients with systolic heart failure with a mean age of 68.6 years (59% men, 73% Caucasian). Following covariate adjustment, better global cognitive function, attention, and executive function were related to decreased mortality risk. CONCLUSIONS:Future research is needed to clarify the underlying mechanisms of the association between cognitive impairment and mortality.

SUBMITTER: Gathright EC

PROVIDER: S-EPMC6916714 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Examination of attention, executive function, and memory as predictors of mortality risk in adults with systolic heart failure.

Gathright Emily C EC Dolansky Mary A MA Gunstad John J Josephson Richard A RA Moore Shirley M SM Hughes Joel W JW

European journal of cardiovascular nursing 20190725 8

<h4>Background</h4>The prevalence and impact of cognitive impairment in heart failure is increasingly recognized. Converging evidence points to global cognitive function as predictive of prognosis in adults with heart failure when assessed with screening tools. Additional work is needed to understand which domains of cognitive function are most relevant for prognosis.<h4>Aims</h4>The present study sought to examine associations between domains of cognitive function and mortality risk in adults w ...[more]

PMID: 31342781

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Project description:BackgroundThe prevalence of combined heart failure (HF) and atrial fibrillation (AF) is rising, and these patients suffer from high rates of mortality. This study aims to provide robust data on factors associated with death, uniquely supported by post-mortem examination.MethodsA retrospective cohort study of hospitalized adults with a clinical diagnosis of HF and AF at a tertiary centre in Romania between 2014 and 2017. A standardized post-mortem examination was performed where death occurred within 24 h of admission, when the cause of death was not clear or by physician request. National records were used to collect mortality data, subsequently categorized and analysed as HF-related death, vascular death and non-cardiovascular death using Cox proportional hazards regression.ResultsA total of 1009 consecutive patients with a mean age of 73 ± 11 years, 47% women, NYHA class 3.0 ± 0.9, left ventricular ejection fraction (LVEF) 40.1 ± 11.0% and 100% anticoagulated were followed up for 1.5 ± 0.9 years. A total of 291 (29%) died, with post-mortems performed on 186 (64%). Baseline factors associated with mortality were dependent on the cause of death. HF-related death in 136 (47%) was associated with higher NYHA class (hazard ratio [HR] 2.45 per one class increase, 95% CI 1.73-3.46; p < 0.001) and lower LVEF (0.95 per 1% increase, 0.93-0.97; p < 0.001). Vascular death occurred in 75 (26%) and was associated with hypertension (HR 2.83, 1.36-5.90; p = 0.005) and higher LVEF (1.08 per 1% increase, 1.05-1.11; p < 0.001). Non-cardiovascular death in 80 (28%) was associated with clinical obesity (HR 2.20, 1.21-4.00; p = 0.010) and higher LVEF (1.10 per 1% increase, 1.06-1.13; p < 0.001). Across all causes, there was no relationship between mortality and AF type (p = 0.77), HF type (p = 0.85) or LVEF (p = 0.58).ConclusionsSupported by post-mortem data, the cause of death in HF and AF patients is heterogeneous, and the relationships with typical markers of mortality are critically dependent on the mode of death. The poor prognosis in this group demands further attention to improve management beyond anticoagulation.

Dataset Information

Examination of attention, executive function, and memory as predictors of mortality risk in adults with systolic heart failure.

Publications

Examination of attention, executive function, and memory as predictors of mortality risk in adults with systolic heart failure.

Similar Datasets

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