Comprehensive treatment improves cognitive impairment in heart failure patients

April 29, 2005

It is common for patients in heart failure to show cognitive dysfunction, known in the past as "cardiogenic dementia." However, by evaluating and treating some coexisting conditions observed in these patients, such as salt imbalances, anemia and hyperglycemia, their cognitive functions may improve independently of the underlying cardiac problems.

In a study published in the current issue of The American Journal of Medicine, researchers from the Catholic University, Rome, Italy and Wake Forest University, Winston-Salem, North Carolina examined records from 16,913 patients. Of these, 1511 suffered heart failure and 526 (35%) also exhibited cognitive dysfunction. Low serum albumin, sodium and potassium levels, hyperglycemia, anemia, and systolic blood pressure levels were independently associated with cognitive impairment.

According to Dr. Giuseppe Zuccalà, "The issue of cognitive impairment associated with heart failure does not represent a mere academic question...Among older patients with heart failure, cognitive dysfunction has been associated with a fivefold increase in the risk of mortality, and a sixfold increase in the probability of dependence for the activities of daily living."

Treating cognitive dysfunction independently may yield benefits. Dr. Zuccalà continues, "Our data indicate that normalization of glucose, potassium, and hemoglobin levels during hospital stay is associated with increased cognitive performance at discharge. This confirms the need for a comprehensive approach to heart failure in older populations."
The study is reported in "Correlates of Cognitive Impairment among Patients with Heart Failure: Results of a Multicenter Survey" by Giuseppe Zuccalà, Emanuele Marzetti, Matteo Cesari, Maria R. Lo Monaco, Livia Antonica, Alberto Cocchi, Pierugo Carbonin, Roberto Bernabei. This article appears in The American Journal of Medicine, Volume 118, Number 5 (May 2005), published by Elsevier.

Elsevier Health Sciences

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