Heart Failure and Impaired Cognitive Function: Findings From the National Health and Nutrition Examination Survey (NHANES)

Author Type(s)

Student

Document Type

Article

Publication Date

4-5-2024

DOI

10.1016/S0735-1097%2824%2902598-1

Journal Title

Journal of the American College of Cardiology

Abstract

Background

The relationship between heart failure (HF) and cognitive impairment has not been clearly delineated. The primary objective of this analysis was to determine whether patients with HF have greater cognitive impairment compared with those without HF using the NHANES continuous dataset (n=111,797) from 1999 to 2021.

Methods

A total of 5951 patients aged ≥60 years were identified with cognition scores from the Digit Symbol Substitution Test (DSST), a measure of range of cognitive functions. Univariate correlation between HF and cognitive function as measured by the DSST was performed. A multivariate model was constructed to examine the effect of potential predictors: HF, sex, age, race, education, diabetes, body mass index, smoking, hypertension, cholesterol, coronary artery disease, depression, stroke and alcohol use. Propensity score adjustment (PSA) was performed using inverse probability treatment weighting in a third linear model.

Results

Mean DSST scores were significantly lower (P< 0.0001) for those with HF (35.2) than for those without (43.8), with a mean difference of 8.5 (95% confidence interval: 6.7-10.3). After adjustment for baseline covariates using PSA, patients with HF had a leastsquares mean difference of approximately 4.2 points lower than those without HF (P=0.0009).

Conclusion

A significant reduction was found in cognitive function in patients with HF after adjusting for potential confounders and baseline covariates. The lower score in patients with HF is within the range of mild cognitive impairment.

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