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The Prevalence of Cognitive Impairment Among Adults With Incident Heart Failure: The "Reasons for Geographic and Racial Differences in Stroke" (REGARDS) Study.

TitleThe Prevalence of Cognitive Impairment Among Adults With Incident Heart Failure: The "Reasons for Geographic and Racial Differences in Stroke" (REGARDS) Study.
Publication TypeJournal Article
Year of Publication2019
AuthorsSterling MR, Jannat-Khah D, Bryan J, Banerjee S, McClure LA, Wadley VG, Unverzagt FW, Levitan EB, Goyal P, Peterson JC, Manly JJ, Levine DA, Safford MM
JournalJ Card Fail
Volume25
Issue2
Pagination130-136
Date Published2019 Feb
ISSN1532-8414
KeywordsAged, Cognition, Cognitive Dysfunction, Continental Population Groups, Female, Follow-Up Studies, Heart Failure, Humans, Incidence, Male, Prevalence, Retrospective Studies, Risk Factors, United States
Abstract

BACKGROUND: Cognitive impairment (CI) is estimated to be present in 25%-80% of heart failure (HF) patients, but its prevalence at diagnosis is unclear. To improve our understanding of cognition in HF, we determined the prevalence of CI among adults with incident HF in the REGARDS study.

METHODS AND RESULTS: REGARDS is a longitudinal cohort study of adults ≥45 years of age recruited in the years 2003-2007. Incident HF was expert adjudicated. Cognitive function was assessed with the Six-Item Screener. The prevalence of CI among those with incident HF was compared with the prevalence of CI among an age-, sex-, and race-matched cohort without HF. The 436 participants with incident HF had a mean age of 70.3 years (SD 8.9), 47% were female, and 39% were black. Old age, black race, female sex, less education, and anticoagulation use were associated with CI. The prevalence of CI among participants with incident HF (14.9% [95% CI 11.7%-18.6%]) was similar to the non-HF matched cohort (13.4% [11.6%-15.4%]; P < .43).

CONCLUSIONS: A total of 14.9% of the adults with incident HF had CI, suggesting that the majority of cognitive decline occurs after HF diagnosis. Increased awareness of CI among newly diagnosed patients and ways to mitigate it in the context of HF management are warranted.

DOI10.1016/j.cardfail.2018.12.006
Alternate JournalJ. Card. Fail.
PubMed ID30582968
PubMed Central IDPMC6377841
Grant ListR03 AG056446 / AG / NIA NIH HHS / United States
T32 HS000066 / HS / AHRQ HHS / United States
U01 NS041588 / NS / NINDS NIH HHS / United States
R01 HL080477 / HL / NHLBI NIH HHS / United States
K23 AG042869 / AG / NIA NIH HHS / United States
Division: 
Biostatistics
Category: 
Faculty Publication