Cognitive impairment in heart failure: clinical implications, tools of assessment, and therapeutic considerations

Liori, Sotiria; Arfaras-Melainis, Angelos; Bistola, Vasiliki; Polyzogopoulou, Eftihia; Parissis, John

doi:10.1007/s10741-021-10118-5

Cited by 14 publications

(12 citation statements)

References 51 publications

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“…Adults with HF often experience a variety of illness-related issues that complicate self-care. Heart failure causes neurohormonal, inflammatory, and hemodynamic abnormalities, all of which are thought to contribute to cognitive impairment 21 . Approximately 70% of patients with HF have at least mild cognitive impairment, which has been shown to be associated with poor self-care 22 .…”

Section: Problem Person and Environmental Factorsmentioning

confidence: 99%

“…Heart failure causes neurohormonal, inflammatory, and hemodynamic abnormalities, all of which are thought to contribute to cognitive impairment. 21 Approximately 70% of patients with HF have at least mild cognitive impairment, which has been shown to be associated with poor self-care. 22 This association is not surprising, because self-care behaviors require memory and cognitive skills (eg, remembering to take medications and understanding symptom changes).…”

Section: Problem Person and Environmental Factorsmentioning

confidence: 99%

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The Situation-Specific Theory of Heart Failure Self-care

2022

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Many studies of heart failure (HF) self-care have been conducted since the last update of the situation-specific theory of HF self-care. Objective The aim of this study was to describe the manner in which characteristics of the problem, person, and environment interact to influence decisions about self-care made by adults with chronic HF. Methods This study is a theoretical update. Literature on the influence of the problem, person, and environment on HF self-care is summarized. Results Consistent with naturalistic decision making, the interaction of the problem, person, and environment creates a situation in which a self-care decision is needed. Problem factors influencing decisions about HF self-care include specific conditions such as cognitive impairment, diabetes mellitus, sleep disorders, depression, and symptoms. Comorbid conditions make HF self-care difficult for a variety of reasons. Person factors influencing HF self-care include age, knowledge, skill, health literacy, attitudes, perceived control, values, social norms, cultural beliefs, habits, motivation, activation, self-efficacy, and coping. Environmental factors include weather, crime, violence, access to the Internet, the built environment, social support, and public policy. Conclusions A robust body of knowledge has accumulated on the person-related factors influencing HF self-care. More research on the contribution of problem-related factors to HF self-care is needed because very few people have only HF and no other chronic conditions. The research on environment-related factors is particularly sparse. Seven new propositions are included in this update. We strongly encourage investigators to consider the interactions of problem, person, and environmental factors affecting self-care decisions in future studies.

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Section: Problem Person and Environmental Factorsmentioning

confidence: 99%

Section: Problem Person and Environmental Factorsmentioning

confidence: 99%

The Situation-Specific Theory of Heart Failure Self-care

2022

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“…However, there is no consensus on the best tools that can be used for cognitive assessment in clinical practice. While studies have shown that both Montreal Cognitive Assessment (MoCA) and Mini‐Mental State Examination (MMSE) are valid screening tools for cognitive impairment following stroke 30 and HF, 31 another study suggested that MoCA might not be sensitive enough to detect subtle cognitive changes in the early stages and recommended that cognition in individuals at different stages of the CVD continuum be assessed through a complete neuropsychological evaluation using cognitive assessments that target memory and executive functions and verbal fluency 32 . Good cognitive performance supports adherence to medication, self‐care, and the ability to retain disease‐related knowledge, 33 which could also help prevent recurrence of another incident CVD, further emphasizing the importance of preventing CVD events in order to maintain cognitive function and independence in older adults.…”

Section: Discussionmentioning

confidence: 99%

Cognitive trajectories and incident dementia after a cardiovascular event in older adults

Vishwanath

Hopper

Wolfe

et al. 2023

Alzheimer's & Dementia

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INTRODUCTIONCardiovascular disease (CVD) is a recognized risk factor for dementia. Here we determined the extent to which an incident CVD event modifies the trajectory of cognitive function and risk of dementia.METHODS19,114 adults (65+) without CVD or dementia were followed prospectively over 9 years. Incident CVD (fatal coronary heart disease, nonfatal myocardial infarction [MI], stroke, hospitalization for heart failure) and dementia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) were adjudicated by experts.RESULTSNine hundred twenty‐two participants had incident CVD, and 44 developed dementia after CVD (4.9% vs. 4.4% for participants without CVD). Following a CVD event there was a short‐term drop in processing speed (−1.97, 95% confidence interval [CI]: −2.57 to −1.41), but there was no significant association with longer‐term processing speed. In contrast, faster declines in trajectories of global function (−0.56, 95% CI: −0.76 to −0.36), episodic memory (−0.10, 95% CI: −0.16 to −0.04), and verbal fluency (−0.19, 95% CI: −0.30 to −0.01) were observed.DISCUSSIONFindings highlight the importance of monitoring cognition after a CVD event.

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“…The BBB is crucial in preventing metabolic waste and harmful substances from passing into the central nervous system through the blood circulation ( Liori et al, 2022 ). The pathophysiology of CI linked to HF is greatly influenced by aberrant BBB function, which includes pericellular breakdown, endothelial cell activation, and an excessively tight linkage between endothelium and pericellular ( Ritz et al, 2013 ).…”

Section: Pathogenesis Of Hf With CImentioning

confidence: 99%

Heart failure and cognitive impairment: A narrative review of neuroimaging mechanism from the perspective of brain MRI

Bao

et al. 2023

Front. Neurosci.

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Both heart failure (HF) and cognitive impairment (CI) have a significant negative impact on the health of the elderly individuals. Magnetic resonance imaging (MRI) can non-invasively detect functional and structural variations in the heart and brain, making it easier to explore the connection between the heart and brain. According to neuroimaging studies, HF patients have a higher chance of developing CI because they have a variety of different types of brain injuries. To examine how HF and CI are influenced by one another, English-language literature was searched in the Web of Science, PubMed EMBASE (OVID), PsycInfo, and Scopus databases. The search terms included “high-frequency,” “brain function,” “brain injury,” “cognition,” “cognitive impairment,” and “magnetic resonance imaging.” Normal brain function is typically impaired by HF in the form of decreased cerebral perfusion pressure, inflammation, oxidative stress, and damage to the BBB, resulting in CI and subsequent HF. Early pathophysiological alterations in patients’ brains have been widely detected using a range of novel MRI techniques, opening up new avenues for investigating the connection between HF and CI. This review aims to describe the pathogenesis of HF with CI and the early diagnostic role of MRI in the heart-brain domain.

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Cognitive impairment in heart failure: clinical implications, tools of assessment, and therapeutic considerations

Cited by 14 publications

References 51 publications

The Situation-Specific Theory of Heart Failure Self-care

The Situation-Specific Theory of Heart Failure Self-care

Cognitive trajectories and incident dementia after a cardiovascular event in older adults

Heart failure and cognitive impairment: A narrative review of neuroimaging mechanism from the perspective of brain MRI

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