![]() The Ethics Committee of the Saarland Medical Association approved this study. Written informed consent was obtained from each study participant. After enrolment, 10 patients had to be excluded due to non-compliance with the study protocol ( n = 2), death ( n = 3), dementia ( n = 1), unexpected surgical procedures ( n = 3), or seizures ( n = 1), yielding a final sample of 60 individuals: 20 patients with decompensated CHF, 20 age- and gender-matched patients with stable CHF, as well as 20 age- and gender-matched healthy controls (see below). Thirty of the decompensated CHF patients met the inclusion criteria ( Table 1). Fifty-five patients declined participation mainly after information about the extent of the investigation (duration of ∼2–3 h). ![]() Considering the interactions between depression and cognition, 23 screened patients were not included because of a clinically relevant depression. Of these patients, 92 were excluded because of the need for artificial respiration ( n = 9) or resuscitation within the last 3 months ( n = 5). A total of 122 patients were admitted suffering from symptoms of decompensation. Methods Participantsįrom December 2008 to December 2009, we screened 253 subjects ( Figure 1). We analysed cognitive function, depression, and quality of life in patients with stable, decompensated, and compensated CHF, and in age- and gender-matched healthy controls by means of a comprehensive psychometric test battery. It is unknown to what extent cardiac decompensation aggravates cognitive deficits and whether compensation is associated with recovery of these cognitive deficiencies. ![]() 7– 9 Detailed analyses of components of cognitive function in heart failure are not available. 7– 9 Consequently, cognitive dysfunction is correlated with hospitalization, disability, and mortality. 3– 5 Impaired cognitive abilities may result in poorer decision-making capacity and health behaviour practices, which potentially undermines adherence to evidence-based treatments 6 and may negatively affect CHF treatment outcomes. Neuropsychological diagnostics delivers important details for daily life activities and might identify individuals deserving special care.Ĭhronic heart failure (CHF) is associated with both psychological co-morbidities such as depression 1, 2 and impairments in certain cognitive functions such as executive control, attention, and processing speed. Conclusionĭecompensated heart failure patients are highly impaired in cognitive functioning, which improves but does not normalize after compensation. Compared with healthy controls, both patient groups were affected with respect to episodic memory ( P < 0.0001) and fluid intelligence ( P < 0.01). Compensation improved the cognitive performance of decompensated CHF patients up to the level of patients with stable CHF. Patients with decompensated CHF showed significantly poorer performance in terms of short-term memory, working memory, executive control, and processing speed ( P < 0.05) compared with stable CHF patients. Methods and resultsĬognitive performance, self-perceived quality of life, and depression were compared in 20 patients with decompensated CHF before and after compensation, 20 age- and gender-matched stable CHF patients, and 20 healthy controls (EF 70 ± 5%). Cognitive function and psychological co-morbidities are associated with hospitalization, disability, and mortality. Executive functions, episodic memory, and attention are impaired in patients with stable CHF, influencing health behaviour and disease management. The objective of this study was to examine cognitive and psychological processes systematically in patients with decompensated chronic heart failure (CHF) and to document changes in cognitive function after compensation.
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