Cognition, Physical Function, and Quality of Life in Older Patients With Acute Decompensated Heart Failure.

Journal Article (Journal Article)

BACKGROUND: Older adults with acute decompensated heart failure have persistently poor clinical outcomes. Cognitive impairment (CI) may be a contributing factor. However, the prevalence of CI and the relationship of cognition with other patient-centered factors such a physical function and quality of life (QOL) that also may contribute to poor outcomes are incompletely understood. METHODS AND RESULTS: Older (≥60 years) hospitalized patients with acute decompensated heart failure were assessed for cognition (Montreal Cognitive Assessment [MoCA]), physical function (Short Physical Performance Battery [SPPB], 6-minute walk distance [6MWD]), and QOL (Kansas City Cardiomyopathy Questionnaire, Short Form-12). Among patients (N = 198, 72.1 ± 7.6 years), 78% screened positive for CI (MoCA of <26) despite rare medical record documentation (2%). Participants also had severely diminished physical function (SPPB 6.0 ± 2.5 units, 6MWD 186 ± 100 m) and QOL (scores of <50). MoCA positively related to SPPB (ß = 0.47, P < .001), 6MWD ß = 0.01, P = .006) and inversely related to Kansas City Cardiomyopathy Questionnaire Overall Score (ß = -0.05, P < .002) and Short Form-12 Physical Component Score (ß = -0.09, P = .006). MoCA was a small but significant predictor of the results on the SPPB, 6MWD, and Kansas City Cardiomyopathy Questionnaire. CONCLUSIONS: Among older hospitalized patients with acute decompensated heart failure, CI is highly prevalent, is underrecognized clinically, and is associated with severe physical dysfunction and poor QOL. Formal screening may reduce adverse events by identifying patients who may require more tailored care.

Full Text

Duke Authors

Cited Authors

  • Pastva, AM; Hugenschmidt, CE; Kitzman, DW; Nelson, MB; Brenes, GA; Reeves, GR; Mentz, RJ; Whellan, DJ; Chen, H; Duncan, PW

Published Date

  • March 2021

Published In

Volume / Issue

  • 27 / 3

Start / End Page

  • 286 - 294

PubMed ID

  • 32956816

Pubmed Central ID

  • PMC7914148

Electronic International Standard Serial Number (EISSN)

  • 1532-8414

Digital Object Identifier (DOI)

  • 10.1016/j.cardfail.2020.09.007

Language

  • eng

Conference Location

  • United States