Cognitive Decline and Risk of Dementia in Individuals With Heart Failure: A Systematic Review and Meta-analysis |
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| Affiliation: | 1. School of Public Health and Preventive Medicine, Monash University, Victoria, Australia;2. University Heart & Vascular Center Hamburg, Germany;3. Department of Twin Research & Genetic Epidemiology, King''s College London, UK;4. Curtin School of Population Health, Curtin University, Western Australia, Australia;1. From the University of Colorado School of Medicine, Aurora, Colorado;2. Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado;3. Mayo Clinic, Rochester, Minnesota;4. Washington University School of Medicine, St. Louis, Missouri;1. Department of Cardiology, Hospital Universitari de Bellvitge, L''Hospitalet de Llobregat, Barcelona, Spain;2. Bioheart-Cardiovascular Diseases Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d''Investigació Biomèdica de Bellvitge–IDIBELL, L''Hospitalet de Llobregat, Barcelona, Spain;3. Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK;4. Department of Cardiology, North West Heart Centre, Manchester University NHS Foundation Trust, Wythenshawe Campus, UK;5. Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK;6. Wellcome Centre for Cell-Matrix Research, Division of Cell-Matrix Biology & Regenerative Medicine, School of Biology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK;1. Division of Cardiovascular Diseases, Vanderbilt University Medical Center, Nashville, Tennessee;2. Department of Cardiovascular Diseases, University of Kansas Medical Center, Kansas City, Kansas;3. Division of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas;4. Department of Cardiology, Texas Heart Institute, Houston, Texas;5. Division of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee;6. Divisions of General and Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College Medicine, Houston, Texas;7. Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Texas;1. From the Duke University School of Medicine, Durham, NC;2. Merck & Co., Kenilworth, NJ;3. Avalere Health, Washington, D.C;1. Universiti Teknologi MARA (UITM) Sungai Buloh, Selangor, Malaysia;2. Institut Jantung Negara, Kuala Lumpur, Malaysia |
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| Abstract: | ![]()
BackgroundWe sought to determine the association between heart failure (HF) and cognitive change and dementia.Methods and ResultsSystematic search of three electronic databases was performed and 29 eligible studies involving approximately 3 million participants were identified. Twelve studies examined dementia and 20 cognitive change, but only a subset of studies could be included in the meta-analysis. These findings indicated that HF was not significantly associated with dementia (n = 8, hazard ratio 1.18, 95% confidence interval 0.93–1.50), but increased the risk of cognitive impairment (n = 3, hazard ratio 1.80, 95% confidence interval 1.14–2.86) . Additionally, HF was associated with poorer mean cognitive performance in global cognition (Hedges’ g –0.73, 95% confidence interval –1.12 to –0.35), memory (Hedges’ g –0.57, 95% confidence interval –0.72 to –0.42), executive function (Hedges’ g –0.58, 95% confidence interval –0.72 to –0.43), attention/speed (Hedges’ g –0.50, 95% confidence interval –0.63 to –0.37) and language (Hedges’ g –0.61, 95% confidence interval –1.05 to –0.17).ConclusionsPatients with HF perform worse on all cognitive tests and have an increased risk of cognitive impairment. These findings highlight the need for clinicians to consider cognition as part of routine care for patients with HF. |
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