Memory dysfunction, psychomotor slowing, and decreased executive function predict mortality in patients with heart failure and low ejection fraction

Susan J. Pressler, Jinshil Kim, Penny Riley, David L. Ronis, Irmina Gradus-Pizlo

Research output: Contribution to journalArticle

89 Scopus citations

Abstract

Background: The purpose of this study was to evaluate whether dysfunction of specific cognitive abilities is a predictor of impending mortality in adults with systolic heart failure (HF). Methods: A total of 166 stable outpatients with HF completed cognitive function evaluation in language, working memory, memory, visuospatial ability, psychomotor speed, and executive function using a neuropsychological test battery. Demographic and clinical variables, comorbidity, depressive symptoms, and health-related quality of life were also measured. Patients were followed for 12 months to determine all-cause mortality. Results: There were 145 survivors and 21 deaths. In logistic regression analyses, significant predictors of mortality were lower left ventricular ejection fraction (LVEF) and poorer scores on measures of global congnitive function Mini-Mental State Examination [MMSE], working memory, memory, psychomotor speed, and executive function. Memory loss was the most predictive cognitive function variable (overall χ2 = 17.97, df = 2, P < .001; Nagelkerke R2 = 0.20). Gender was a significant covariate in 2 models, with men more likely to die. Age, comorbidity, depressive symptoms, and health-related quality of life were not significant predictors. In further analyses, significant predictors of mortality were lower systolic blood pressure and poorer global cognitive function, working memory, memory, psychomotor speed, and executive function, with memory being the most predictive. Conclusions: As hypothesized, lower LVEF and memory dysfunction predicted mortality. Poorer global cognitive score as determined by the MMSE, working memory, psychomotor speed, and executive function were also significant predictors. LVEF or systolic blood pressure had similar predictive values. Interventions are urgently needed to prevent and manage memory loss in HF.

Original languageEnglish (US)
Pages (from-to)750-760
Number of pages11
JournalJournal of Cardiac Failure
Volume16
Issue number9
DOIs
StatePublished - Sep 1 2010

Keywords

  • cognitive impairment
  • Heart failure
  • memory dysfunction
  • mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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