Cognitive dysfunction in older adults hospitalized for acute heart failure.

ABSTRACT

BACKGROUND: Few studies have measured cognitive dysfunction in older adults during acute exacerbations of heart failure (HF), even though 25% of patients are readmitted within 30 days. The aims of this study were to examine cognitive dysfunction and acute HF symptoms in older adults hospitalized for HF and to evaluate the relationship between cognitive dysfunction and 30-day rehospitalization rates for acute HF. METHODS AND RESULTS: A cross-sectional descriptive design was used to characterize cognitive function in 53 older adults hospitalized for acute HF with the use of Cogstate computerized neuropsychologic tests. Demographic characteristics, HF symptoms (dyspnea, fatigue, pain, and depressed mood), comorbidity, and 30-day readmission HF rates were also measured. Dyspnea was measured with the use of the Parshall Brief Clinical Dyspnea Rating Questionnaire while fatigue was measured with the use of the Chalder et al Brief Fatigue Scale. We measured pain with the use of the Short-Form McGill Pain Questionnaire and depressed mood with the use of the depression subscale of the Hospital Anxiety and Depression Scale. Comorbid conditions were measured with the use of the Charlson comorbidity index. With the use of linear regression, dyspnea (ß = -.281; P = .030), pain (ß = .323; P = .011), and depressed mood (ß = .406, P = .003) were associated with reduced attention and working memory speed, and pain (ß = -.372; P = .005) and fatigue (ß = -.275; P = .033) were associated with reduced accuracy of attention and working memory. Ten patients were readmitted within 30 days for HF. According to Mann-Whitney U analysis, cognitive dysfunction measures (P = .090-.803) failed to show differences in HF readmission. CONCLUSIONS: Participants with more and worse symptoms had decreased speed and decreased accuracy in the cognitive domains tested. Cognitive dysfunction measures did not differentiate participants who were readmitted versus those who were not readmitted within 30 days for acute HF.