Cognitive impairment: a key feature of congestive heart failure in the elderly

Trojano, Luigi; Incalzi, Raffaele Antonelli; Acanfora, Domenico; Picone, C.; Mecocci, Patrizia; Rengo, Franco

doi:10.1007/s00415-003-0249-3

Cited by 147 publications

(155 citation statements)

References 44 publications

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“…Impairment in attention, immediate memory, delayed memory, executive function and psychomotor speed were prevalent in this sample. These findings are congruent with previous findings from the HF literature 11,12,24,25 . 31,32 .…”

Section: Discussionsupporting

confidence: 83%

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

Bauer¹,

Pozehl²,

Hertzog³

et al. 2016

European Journal of Cardiovascular Nursing

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Section: Discussionsupporting

confidence: 83%

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

Bauer¹,

Pozehl²,

Hertzog³

et al. 2016

European Journal of Cardiovascular Nursing

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“…[30] All of which may have contributed to decreased cognitive impairment among the men in this study. [12,31] Worsening physical symptoms contributed to a significant degree of cognitive impairment, [31] a factor that also shaped recurrent hospital admissions and in some cases no compliance with treatments. [32] In this study being a "man" diagnosed with chronic progressive condition challenged the participants' masculinity.…”

Section: Discussionmentioning

confidence: 99%

Bahraini men living with heart failure: A phenomenological study

Mohamed

O’Neill

2017

CNS

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Background: Heart failure (HF) is a worldwide chronic and progressive condition. HF symptoms affect an individual's life perspectives, and create dramatic changes in their everyday living routines. Qualitative studies showed that HF symptoms were associated with reported low quality of life, reduced physical activities, and altered social interactions and relationships. The aim of this study was to explore the experiences of men under the age of 65 diagnosed with HF living in the Kingdom of Bahrain. Methods: An interpretive phenomenological approach was used. In-depth, semi-structured interviews were conducted with six men under the age of 65 who were diagnosed with HF for a period of not less than a year. The interviews were conducted in Arabic, and then translated and transcribed into English. Smith's framework was drawn on for data analysis. Results: Three main themes emerged: the physical burden of the illness; the psychosocial aspects of the illness and living with HF. The findings showed that the physical symptoms shaped men's everyday work activities and also their resting and sleeping patterns. Participants expressed feelings of frustration, anger, and sadness following the diagnosis and recounted how their masculinity roles changed at home and in society. Families played a major role giving support to the men, who utilized different coping strategies, as lifestyle and behavioral modifications were adopted. Keeping faith and a belief in God, coupled with social support was a thread that connected all participants coping strategies. The authors recommend that educational programs for men who are diagnosed with HF and their families would help them cope with this chronic illness. Conclusions: Heart failure patients experience dramatic changes in their life. An understanding of the challenges they are facing in their daily living enables them, and those who care for them, both families and nurses, to creatively assist them live with the difficulties encountered with HF.

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“…[11][12][13] A frequently used serum marker of heart failure is the N-terminal pro-brain natriuretic peptide (NT-proBNP), the inactive fragment of the proBNP hormone. 14 NT-proBNP has proven to be a quantitative marker of acute heart failure in clinical practice, with high sensitivity and reasonable specificity, 15 although elevated NT-proBNP levels are not specific for heart failure in the general population.…”

Section: Discussionmentioning

confidence: 99%

NT-proBNP, blood pressure, and cognitive decline in the oldest old

et al. 2014

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Objective: To study the relation between N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, used as a marker of heart failure in clinical practice, blood pressure (BP), and cognitive decline in the oldest old.Methods: In 560 participants of the Leiden 85-plus Study, we measured NT-proBNP levels and BP at age 85 years, at baseline, and global cognitive function (Mini-Mental State Examination [MMSE]) annually during the follow-up of 5 years.Results: Subjects in the highest tertile of NT-proBNP levels scored 1.7 points lower on the MMSE at age 85 years than subjects in the lowest tertile (p 5 0.004), and had a 0.24-point-steeper decline in MMSE score per year (p 5 0.021). The longitudinal association disappeared after full adjustment for possible confounders (0.14-point-steeper decline, p 5 0.187). Subjects in the category "highest tertile of NT-proBNP and the lowest tertile of systolic BP" had a 3.7-point-lower MMSE score at baseline (p , 0.001) and a 0.49-point-steeper decline in MMSE score per year (p , 0.001) compared with subjects in the other categories. Conclusions:In the oldest old, high NT-proBNP levels are associated with lower MMSE scores. The combination of high NT-proBNP levels and low systolic BP is associated with worst global cognitive function and the steepest cognitive decline. Possibly, a failing pump function of the heart results in lower BP and lower brain perfusion with resultant brain dysfunction. Cardiovascular diseases, such as myocardial infarction, generalized atherosclerosis, and stroke have been associated with increased dementia risk and cognitive decline.1-4 Hypertension, however, is only a risk factor for dementia when present in middle age, whereas most studies show that dementia and cognitive decline in the oldest old associate with lower blood pressures. 5In the oldest old, blood pressures decrease over time, 6,7 and stronger declines are related to the presence of dementia and cognitive decline. 8,9 One possible explanation for the blood pressure decline in the oldest old might be the increasing prevalence of (subclinical) congestive heart failure.10 Despite this dynamic correlation between blood pressure and cardiac function in relation to cognitive function in old age, previous studies have mainly focused on either the association of blood pressure or cardiac function with cognitive impairment.Congestive heart failure has been associated with an increased risk of cognitive impairment. 11-13A frequently used serum marker of heart failure is the N-terminal pro-brain natriuretic peptide (NT-proBNP), the inactive fragment of the proBNP hormone. 14 NT-proBNP has proven to be a quantitative marker of acute heart failure in clinical practice, with high sensitivity and reasonable specificity, 15 although elevated NT-proBNP levels are not specific for heart failure in the general population. Several studies have shown that higher NT-proBNP levels associate with lower cognitive function. 16,17 However, the relation among NT-proBNP levels, blood pressure, and cognitive f...

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Cognitive impairment: a key feature of congestive heart failure in the elderly

Cited by 147 publications

References 44 publications

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

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

Bahraini men living with heart failure: A phenomenological study

NT-proBNP, blood pressure, and cognitive decline in the oldest old

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