Frequent Cognitive Impairment in Patients With Disorders Along the Heart-Brain Axis

Background and Purpose-Patients with cardiovascular disease are at increased risk for cognitive decline. We studied the occurrence and profile of cognitive impairment in 3 patient groups as exemplar conditions of hemodynamic disturbances at different levels of the heart-brain axis, including patients with heart failure (HF), carotid occlusive disease (COD), and patients with cognitive complaints and vascular brain injury on magnetic resonance imaging (possible vascular cognitive impairment [VCI]).Methods-In 555 participants (160 HF, 107 COD, 160 possible VCI, 128 reference participants; 689 years; 36% F; Mini-Mental State Examination 282), we assessed cognitive functioning with a comprehensive test battery. Test scores were transformed into z-scores. Compound z-scores were constructed for: memory, language, attention/psychomotor speed, executive functioning, and global cognitive functioning. We rated cognitive domains as impaired when z-scoreResults-Age, sex, and education adjusted global cognitive functioning z-score was lower in patients with COD (beta [SE]=-0.46 [0.10], PConclusions-A substantial part of patients with HF and COD had cognitive impairment, which warrants vigilance for the occurrence of cognitive impairment. These results underline the importance of an integrative approach in medicine in patients presenting with disorders in the heart-brain axis.