Cognitive status in patients hospitalized with acute decompensated heart failure

UMMS Affiliation

Department of Medicine, Division of Cardiovascular Medicine; Department of Quantitative Health Sciences; Meyers Primary Care Institute; Department of Emergency Medicine; School of Medicine; Senior Scholars Program; Graduate School of Biomedical Sciences, Clinical and Population Health Program

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Cardiology | Cardiovascular Diseases | Mental Disorders


BACKGROUND: Cognitive impairment is highly prevalent in patients with heart failure and is associated with adverse outcomes. However, whether specific cognitive abilities (eg, memory vs executive function) are impaired in heart failure has not been fully examined. We investigated the prevalence of impairment in 3 cognitive domains in patients hospitalized with acute decompensated heart failure (ADHF) and the associations of impairment with demographic and clinical characteristics.

METHODS: The sample included 744 patients hospitalized with ADHF (mean age 72 years, 46% female) at 5 medical centers. Impairment was assessed in 3 cognitive domains (memory, processing speed, executive function) using standardized measures. Demographic and clinical characteristics were obtained from a structured interview and medical record review.

RESULTS: A total of 593 (80%) of 744 patients were impaired in at least 1 cognitive domain; 32%, 31%, and 17% of patients were impaired in 1, 2, or all 3 cognitive domains, respectively. Patients impaired in more than 1 cognitive domain were significantly older, had less formal education, and had more noncardiac comorbidities (all P values < .05). In multivariable adjusted analyses, patients with older age and lower education had higher odds of impairment in 2 or more cognitive domains. Depressed patients had twice the odds of being impaired in all 3 cognitive domains (odds ratio 1.98, 95% CI 1.08-3.64).

CONCLUSION: Impairments in executive function, processing speed, and memory are common among patients hospitalized for ADHF. Recognition of these prevalent cognitive deficits is critical for the clinical management of these high-risk patients.


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DOI of Published Version



Levin SN, Hajduk AM, McManus DD, Darling CE, Gurwitz JH, Spencer FA, Goldberg RJ, Saczynski JS. Cognitive status in patients hospitalized with acute decompensated heart failure. Am Heart J. 2014 Dec;168(6):917-23. doi: 10.1016/j.ahj.2014.08.008. Link to article on publisher's website

Journal/Book/Conference Title

American heart journal


Seth N. Levin participated in this study as a medical student as part of the Senior Scholars research program at the University of Massachusetts Medical School.

Co-author Alexandra M. Hajduk is a doctoral student in the Clinical and Population Health Research Program in the Graduate School of Biomedical Sciences (GSBS) at UMass Medical School.

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