Table 3 Studies examining the relationship between cognitive impairment and outcomes in patients with heart failure

Zuccalà 2003 [37]

1511 HF pts 11,790 controls

All geriatric or general medical admissions

79 (9)

Prospective

Not specified

Not specified

Hodkinson abbreviated mental test

Mean length of hospital stay: pts with CI = 15 ± 10 days; pts without CI = 15 ± 9 days

Length of hospital stay

Inpatient mortality: pts with CI, 18%; pts without CI, 3%

1 year mortality

1-year mortality: pts with CI, 27%; pts without CI, 15%

Karlsson 2005 [32]

146 CHF pts

Age >60 years and outpatients

76 (8)

Prospective

LVEF <45%

Co-morbid psychiatric, neurological or physical illness. Previous diagnosis of CI

HF self-care

Self-care scores were significantly higher in those with MMSE >24 compared to those ≤24

NYHA II–IV

questionnaire

MMSE

Riegel 2007 [38]

29 CHF pts

Outpatients

64 (10)

Cross-sectional

LVSD on echo

Co-morbid psychiatric or physical illness. Previous diagnosis of CI

Self-care of HF index

CI was worse in the poor self-care group compared to the good and expert self-care groups but did not reach level of significance

Clinical HF

DSST

English speaking

Probed memory recall

Cameron 2009 [39]

50 CHF pts

Age >45 years and consecutive hospital admissions

73 (11)

Cross-sectional

Clinical CHF

Co-morbid neurological illness. Previous diagnosis of CI

Self-care of HF index

CI was not a predictor of self-care

LVSD on echo

Cardiac depression scale

English speaking

MMSE

Cameron 2010 [40]

93 CHF pts

Age >45 years and consecutive hospital admissions

73 (11)

Cross-sectional

Clinical CHF

Co-morbid neurological illness. Previous diagnosis of CI

Self-care HF index

CI and self-care management were significantly associated (t = 2.7; P < 0.01)

LVSD on echo

MMSE

English speaking

MoCA

Pulignano 2010 [41]

93 CHF pts

Consecutive outpatients

77 (6)

Cross-sectional

Not specified

Not specified

The European heart failure self-care behaviour scale

MMSE was negatively correlated with self-care behavioural scores (r = 0.58, P < 0.001)

MMSE

Alosco 2013 [42]

110 CHF pts

Age >50 years and <85 years. Outpatients

70 (9)

Prospective

NYHA II-IV

Co-morbid psychiatric, neurological or physical illness. Previous diagnosis of CI

Lawton-Brody instrumental activities of daily living

Poorer performance on 3MS was associated with worse total activities of daily living performance

English speaking

Modified MMSE (3MS)

Harkness 2013 [43]

100 CHF pts

Age >55 years and outpatients

72 (10)

Cross-sectional

Confirmed HF using the Boston criteria

Co-morbid psychiatric illness or previous diagnosis of CI

MoCA

MoCA score of <26 was significantly associated with worse self-care management

LVEF ≤45%

Self-care in HF index

Change in symptoms on previous 3 months

Geriatric Depression Scale

English speaking

Alosco 2013 [42]

175 CHF pts

Age >50 years and <85 years. Outpatients

68 (10)

Cross-sectional

NYHA II-IV

Co-morbid psychiatric, neurological or physical illness. Previous diagnosis of CI

Lawton-Brody instrumental activities of daily living

Poorer executive function was independently associated with poorer total activities of daily living performance

English speaking

Executive function assessed by FAB and LNS