HFSA Calls Attention to Prevalence, Impact of Cognitive Impairment Among Heart Failure Patients

The Heart Failure Society of America has released a new document they hope will call attention to the prevalence, impact, and need to address cognitive impairment among patients with heart failure.

A scientific statement published in the Journal of Cardiac Failure on March 12, 2024, the document provides an overview of the negative impact of cognitive impairment on impact functional abilities, life expectancy, medication management, and self-care as well as outlines best strategies for addressing cognitive impairment as part of care for patients with heart failure.

“Cognitive impairment is not the exception; it’s the norm for our patients with heart failure,” said co-lead author Eiran Z. Gorodeski, MD, MPH, medical director of the Advanced Heart Failure & Transplant Center and the James and Angela Hambrick Center for Cardiac Recovery at University Hospitals Harrington Heart and Vascular Institute. “We as clinicians must invest the extra effort to identify it, and then adjust management accordingly. In this Statement we summarize the state of the art, as well as the challenges and the unknowns.”

A 17-page document citing 142 references, the scientific statement is broken down into 5 sections addressing risk factors for cognitive impairment, implications of cognitive impairment, management of cognitive impairment, integration of cognitive impairment into decision making, and gaps in knowledge and challenges to implementation. The document calls specific attention to 6 consequences of cognitive impairment in heart failure: (1) learning and memory, (2) executive function, (3) complex attention, (4) perceptual-motor function, (5) language, and (6) social cognition.

As highlighted by the document, cognitive impairment, even at mild levels, can have a significant impact on quality of life and independent functioning of patients with heart failure. Included in the document is a set of 4 tables outlining key definitions, clues to cognitive impairment, cognitive impairment screenings tools, and strategies for optimizing self-care in patients with cognitive impairment.

“A core priority for the HFSA is to improve heart failure care. Thanks to the work done by the co-authors of this HFSA Scientific Statement, cognitive impairment has been highlighted as a big part of the overall holistic care for patients living with heart failure,” said HFSA President, James C. Fang, MD, of the University of Utah.² “Increasing our attention to this important co-morbidity will ensure our patients receive comprehensive care. "

For more perspective on the document and the need for better prevention, screening, and management of cognitive impairment in patients with heart failure, check out our interview with Gorodeski.

Relevant disclosures for Gorodeski include Abbott, Boston Scientific, and Masimo.

References:

1. _{^{Goyal P, DiDomenico RJ, Pressler SJ, Allen LA, Gorodeski EZ. Cognitive Impairment in Heart Failure: A Heart Failure Society of America Scientific Statement. Journal of Cardiac Failure. Published online March 12, 2024. doi:10.1016/j.cardfail.2024.01.003}}
2. _{^{High prevalence of cognitive impairment in patients with heart failure shown to negatively impact disease self-management. HFSA. March 12, 2024. Accessed March 12, 2024. https://hfsa.org/high-prevalence-cognitive-impairment-patients-heart-failure-shown-negatively-impact-disease-self.}}