A brief neuropsychological battery for use in the chronic heart failure population

Abstract

Background Cognitive impairment is a recognized consequence of heart failure; however, there are no neuropsychological batteries with documented psychometric data in the chronic heart failure population. Aims To document the psychometric properties of a brief neuropsychological battery in a chronic heart failure sample. Methods The Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Test Part A and Part B, and letter fluency was administered to a sample of individuals with chronic heart failure. Results Eighty individuals with stable heart failure participated in this study. Individuals with chronic heart failure scored significantly lower than expected age and education adjusted norms in the domains of attention (p < 0.001), memory (p < 0.001), language (p < 0.001), executive function (p < 0.001), and psychomotor speed (p = 0.02). Scores on the tests of memory and executive function correlated to functional status (r = 0.28, p = 0.02 and r = 0.29, p = 0.03, respectively). Acceptable convergent validity and test–retest reliability were documented for this battery. Conclusion The neuropsychological battery had adequate reliability and validity in individuals with chronic heart failure.

The MoCA and MMSE as screeners for cognitive impairment in a heart failure population: A study with comprehensive neuropsychological testing

“…Thus, our findings may not generalize to other populations, including younger, non-white individuals, inpatients, or those with Class I or IV HF, preserved EF, and/or lower education levels. Next, we did not use age- and education-matched data from individuals with chronic heart failure in our norming procedure; however, this limitation is mitigated by previous work documenting that age- and education-matched norms from non-HF populations is an acceptable alternative to having chronic HF controls [36]. Lastly, although we used a comprehensive neuropsychological battery assessing several cognitive domains, our assessment of visuospatial ability was comprised of a single test, thereby potentially reducing its validity and reliability.…”

“…Of note, although these norms were not specific to HF populations, similar norming procedures have been used for other neuropsychological studies of patients with HF, and Bauer et al. [36] have indicated that using age- and education-matched norms from non-HF populations is an acceptable alternative to chronic HF controls. The scaled scores were converted to T-scores to facilitate interpretation ( M = 50, SD = 10).…”

The older patient with heart failure: high risk for frailty and cognitive impairment

“…In a population sample of community-dwelling adults (n = 650; age range: 75-85 years), individuals with HF at baseline were more likely to experience a significant decline in cognitive function over the subsequent 5 years (relative risk: 1.83; 95% CI: 1.02-3.27) than individuals without HF at baseline [114]. Difficulties with memory, attention, psychomotor speed, verbal learning and executive functions are the most common types of cognitive deficits reported in HF patients [115][116][117][118]. However, it is not clear whether there is a typical profile of cognitive deficits in HF patients or how this profile evolves over time [116].…”

‘Hearts and minds’: association, causation and implication of cognitive impairment in heart failure

“…Ambulatory outpatients onlyHF: 63 (14)Healthy controls: 63 (14)Case controlDiagnosis of HF >6 monthsCo-morbid psychiatric or neurological illnessLVEF ≤40%NYHA II-IVMultidomain neuropsychiatric batterySystolic HF pts scored lower than control group in domain of verbal memoryPressler 2010 [21]249 HF ptsAmbulatory outpatients onlyHF: 63 (15)Cross-sectionalHF: LVEF ≤40% and clinical HFCo-morbid psychiatric, neurological or physical illness. Previous diagnosis of CINYHAMultidomain neuropsychiatric batteryHF group performed worse than healthy and general medical groups in domains of memory, executive function and psychomotor speed63 healthy controlsHealthy controls: 53 (17)Healthy controls: absence of any medical condition or controlled CV risk factorsLVEF102 general medical ptsMedical group: 63 (12)Medical group: major chronic disorder other than HFBauer 2012 [22]51 HF-REF, 29 HF-PEFAge >21 years and ambulatory outpatients only72 (12)Cross-sectionalHF-REF: history of HF-REF >6 months, stable on medication >4 weeks, LVEF ≤40%Co-morbid psychiatric, neurological or physical illness. Previous diagnosis of CILVEFMultidomain neuropsychiatric batteryHF-REF and HF-PEF pts performed worse than age- and educated-adjusted healthy control groups in executive function, attention, language, memory and psychomotor speedHF-PEF: history of HF-PEF >6 months, stable on medication >4 weeks, LVEF >41%NYHAFesta 2011 [23]169 HF-REF, 38 HF-PEFAge >17 years and ambulatory outpatients only69RetrospectiveOn medical treatment for HFCo-morbid neurological illnessLVEFMultidomain neuropsychiatric batteryLow EF was associated with poor memory in pts over 63 years oldHaemodynamically stablePts <63 years old had preserved memory function regardless of EF.Not receiving mechanical circulatory supportSteinberg 2011 [24]55 HF ptsAmbulatory outpatients only55 (8)Cross-sectionalStable clinical statusCo-morbid neurological or physical illness.…”