Cognitive function and related factors in patients with heart failure

Background: Impaired cognitive function is associated with poor outcomes, frequent hospitalization, and high mortality in HF. Purpose: To determine the prevalence of cognitive function in HF and what factors contribute. Method: This study was an observational analysis with cross-sectional. Study subjects: HF patients at the Cardiac Polyclinic of Dr. M. Haulussy Hospital, Ambon, Indonesia from August to September 2023, with Inclusion criteria: aged 40-65 years; able to communicate well; not having a stroke or other neurological disorders (Parkinson's disease, Alzeimer's disease, Multiple Sclerosis) or other cognitive function disorders (such as due to injury or substance abuse); can read and write. Exclusion criteria: worsening of physical condition such as loss of consciousness and worsening of symptoms such as severe shortness of breath, inability to communicate, inability to complete the questionnaire, and worsening of symptoms that do not improve after being rested when data collection is carried out. Results: HF patients were male (56.2%), had ≥ 12 years of education (72.4%), were not actively working (56.9%), suffered from HF with NYHA class II functional status (49.1%), had Coronary Artery Disease (CAD) comorbid only (49.2%), had experienced hospitalization (64.6%), and were obese (51.54%). Respondents had an average age of 57.08 ± 6.78 years, a duration of HF of 3.96 ± 4.35 years, an average body mass index of 25.65 ± 4.5 Kg/m2, normal blood pressure with an average systole of 122.73 ± 17.21 mmHg, and an average diastole of 77.44 ± 10.11 mmHg. HF patients who experienced impaired cognitive function were 87.69% with mild cognitive impairment 73.1%, moderate cognitive impairment 13.1%, and severe cognitive impairment 1.5%. The maximum score of MoCA sub-domains of executive function was 46.2%; visuospatial 35.4%; attention 37.7%, naming and language 20%; abstraction 33.8%, delayed memory 3.8% and orientation 86.9%. There was a significant correlation between cognitive function and age (ρ = 0.000; r = -0.324), education level (ρ = 0.000; r = 0.327), and New York Heart Association functional status (ρ = 0.021; r = -202). Conclusion: There is a high prevalence of impaired cognitive function in chronic HF patients accompanied by a global decline in cognitive function subdomains.  Factors that may contribute to HF cognitive function include age, education level, not actively working, New York Heart Association functional status, comorbidities, and obesity.