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Nijskens CM, Thomas EG, Rhodius‐Meester HFM, Daemen MJAP, Biessels GJ, Handoko ML, Muller M. Is it time for Heart-Brain clinics? A clinical survey and proposition to improve current care for cognitive problems in heart failure. Clin Cardiol 2024; 47:e24200. [PMID: 38183320 PMCID: PMC10785189 DOI: 10.1002/clc.24200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/20/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Cognitive impairment is highly prevalent among patients with heart failure (HF). International guidelines on the management of HF recommend screening for cognitive impairment and tailored care for patients with cognitive impairment. However, practical guidance is lacking. In this study, we explore cardiologists' perspective on screening and care for cognitive impairment in patients with HF. We give an example of a multidisciplinary Heart-Brain care pathway that facilitates screening for cognitive impairment in patients with HF. METHODS We distributed an online survey to cardiologists from the Dutch working groups on Geriatric Cardiology and Heart Failure. It covered questions about current clinical practice, impact of cognitive impairment on clinical decision-making, and their knowledge and skills to recognize cognitive impairment. RESULTS Thirty-six out of 55 invited cardiologists responded. Only 3% performed structured cognitive screening, while 83% stated that not enough attention is paid to cognitive impairment. More than half of the cardiologists desired more training in recognizing cognitive impairment and three-quarters indicated that knowing about cognitive impairment would change their treatment plan. Eighty percent agreed that systematic cognitive screening would benefit their patients and 74% wished to implement a Heart-Brain clinic. Time and expertise were addressed as the major barriers to screening for cognitive impairment. CONCLUSION Although cardiologists are aware of the clinical relevance of screening for cognitive impairment in cardiology patients, such clinical conduct is not yet commonly practiced due to lack of time and expertise. The Heart-Brain care pathway could facilitate this screening, thus improving personalized care in cardiology.
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Affiliation(s)
- Charlotte M. Nijskens
- Department of Internal Medicine, Geriatrics SectionAmsterdam UMC Location Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- Amsterdam Public HealthAmsterdam UMCAmsterdamThe Netherlands
| | - Elias G. Thomas
- Department of Internal Medicine, Geriatrics SectionAmsterdam UMC Location Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- Amsterdam Public HealthAmsterdam UMCAmsterdamThe Netherlands
| | - Hanneke F. M. Rhodius‐Meester
- Department of Internal Medicine, Geriatrics SectionAmsterdam UMC Location Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- Department of Neurology, Alzheimer Center AmsterdamAmsterdam UMC Location Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- Department of Geriatric MedicineOslo University HospitalOsloNorway
- Amsterdam NeuroscienceAmsterdam UMCAmsterdamThe Netherlands
| | - Mat J. A. P. Daemen
- Department of PathologyAmsterdam UMC Location University of AmsterdamAmsterdamThe Netherlands
- Amsterdam Cardiovascular SciencesAmsterdam UMCAmsterdamThe Netherlands
| | - Geert Jan Biessels
- Department of Neurology, UMC Utrecht Brain CenterUniversity Medical CenterUtrechtThe Netherlands
| | - M. Louis Handoko
- Amsterdam Cardiovascular SciencesAmsterdam UMCAmsterdamThe Netherlands
- Department of CardiologyAmsterdam UMC Location Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Majon Muller
- Department of Internal Medicine, Geriatrics SectionAmsterdam UMC Location Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- Amsterdam Public HealthAmsterdam UMCAmsterdamThe Netherlands
- Amsterdam Cardiovascular SciencesAmsterdam UMCAmsterdamThe Netherlands
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Tanaka K, Kikutani T, Tamura F, Sato S, Komagata Y, Shibasaki I, Tomioka K, Ichikawa Y, Shiobara Y, Sato T, Tohara T. Problems experienced when swallowing solid oral dosage forms in older Japanese patients with dysphagia: A cross-sectional study. Spec Care Dentist 2024; 44:214-220. [PMID: 37029091 DOI: 10.1111/scd.12853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 03/17/2023] [Accepted: 03/17/2023] [Indexed: 04/09/2023]
Abstract
AIMS We aimed to assess the difficulty in taking solid oral dosage forms (SODFs) among older people with dysphagia and clarify the relationship between difficulty in swallowing SODFs and swallowing function. METHODS AND RESULTS Outpatients from a dysphagia clinic aged ≥65 years were asked yes-or-no questions about the applicability of eight items regarding difficulty in taking SODFs. Additionally, a videofluorographic swallowing study (VFSS) was performed to assess their swallowing function. The Kruskal-Wallis test and Spearman's rank correlation coefficient were used to analyze the relationship between difficulty in taking SODFs and swallowing function. RESULTS Among the 93 participants, the average number of SODFs consumed was 5.8 ± 3.1. In the questionnaire, the average number of "yes" answers was 2.2 ± 2.2, and 65 patients (71.0%) answered "yes" to at least one question. Additionally, no significant relationship was observed between the perceived difficulty in swallowing SODFs and VFSS findings. CONCLUSION Approximately 70% of participants reported subjective difficulty in taking SODFs, showing that patients uniformly reported perceived difficulty in taking SODFs regardless of actual swallowing function. The results of this study suggest that patients must be questioned thoroughly about their SODFs use, regardless of the objective severity of their dysphagia.
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Affiliation(s)
- Kumi Tanaka
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Koganei, Tokyo, Japan
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Koganei-city, Tokyo, Japan
| | - Takeshi Kikutani
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Koganei, Tokyo, Japan
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Koganei-city, Tokyo, Japan
| | - Fumiyo Tamura
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Koganei, Tokyo, Japan
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Koganei-city, Tokyo, Japan
| | - Shiho Sato
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Koganei, Tokyo, Japan
| | - Yuka Komagata
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Koganei, Tokyo, Japan
| | - Ikumi Shibasaki
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Koganei, Tokyo, Japan
| | - Kosei Tomioka
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Koganei, Tokyo, Japan
| | - Yoko Ichikawa
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Koganei, Tokyo, Japan
| | - Yuichiro Shiobara
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Koganei, Tokyo, Japan
| | - Takanobu Sato
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Koganei, Tokyo, Japan
| | - Takashi Tohara
- Division of Rehabilitation for Speech and Swallowing Disorders, The Nippon Dental University, Koganei, Tokyo, Japan
- The Nippon Dental University, Tama Oral Rehabilitation Clinic, Koganei-city, Tokyo, Japan
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Caramanna I, Reijneveld JC, van de Ven PM, van den Bent M, Idbaih A, Wick W, Taphoorn MJB, Dirven L, Bottomley A, Klein M. Association between objective neurocognitive functioning and neurocognitive complaints in recurrent high-grade glioma: longitudinal evidence of cognitive awareness from EORTC brain tumor trials. Eur J Cancer 2023; 186:38-51. [PMID: 37028200 DOI: 10.1016/j.ejca.2023.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND Patients' reduced awareness of neurocognitive functioning (NCF) may negatively affect the reliability of patient-reported outcomes (PROs) and clinical decision-making. This study evaluated cognitive awareness, defined as the association between NCF and neurocognitive complaints, over the disease course of patients with recurrent high-grade glioma (HGG). METHODS We assessed NCF using the EORTC core clinical trial battery and neurocognitive complaints using the Medical Outcome Study questionnaire. Patients were categorised as impaired or intact, based on their neurocognitive performance. Spearman's rank correlations were calculated between NCF and neurocognitive complaints at baseline and each 12 weeks, until 36. The association between changes in NCF and neurocognitive complaints scores between these follow-up assessments was determined using Pearson's correlation. RESULTS A total of 546 patients were included. Neurocognitively impaired patients (n = 437) had more neurocognitive complaints (range: 10.51 [p < 0.001] to 13.34 [p = 0.001]) than intact patients (n = 109) at baseline, at 12 and 24 weeks. In intact patients, NCF and neurocognitive complaints were correlated for only one domain at baseline (0.202, p = 0.036), while in impaired patients correlations were more frequently found in various domains and time points (range: 0.164 [p = 0.001] to 0.334 [p = 0.011]). Over the disease course, NCF and neurocognitive complaints were correlated for only one domain at baseline (0.357, p = 0.014) in intact patients while in impaired patients they were correlated for more domains and time points (range: 0.222 [p < 0.001] to 0.366 [p < 0.001]). CONCLUSION Neurocognitively impaired patients with recurrent HGG are aware of their neurocognitive limitations at study entry and during follow-up, which should be considered in clinical decision-making and when interpreting PRO results.
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Affiliation(s)
- Ivan Caramanna
- Amsterdam UMC location Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam, The Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Brain Tumor Center, Amsterdam, The Netherlands.
| | - Jaap C Reijneveld
- Amsterdam UMC location Vrije Universiteit Amsterdam, Brain Tumor Center, Amsterdam, The Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Neurology, Amsterdam, The Netherlands; Department of Neurology, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands.
| | - Peter M van de Ven
- Department of Data Science and Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Martin van den Bent
- Brain Tumor Center at Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
| | - Ahmed Idbaih
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, AP-HP, Hôpital Universitaire La Pitié Salpêtrière, DMU Neurosciences, Paris, France.
| | - Wolfgang Wick
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) & Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Haaglanden Medical Center, Hague, The Netherlands.
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Haaglanden Medical Center, Hague, The Netherlands.
| | - Andrew Bottomley
- Quality of Life Department, European Organization for Research and Treatment of Cancer, Brussels, Belgium.
| | - Martin Klein
- Amsterdam UMC location Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam, The Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Brain Tumor Center, Amsterdam, The Netherlands.
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Adachi T, Tsunekawa Y, Matsuoka A, Tanimura D. Association between Rapid Dementia Screening Test score and clinical events in elderly patients with cardiovascular disease: a retrospective cohort study. Eur J Cardiovasc Nurs 2022; 21:840-847. [PMID: 35534944 DOI: 10.1093/eurjcn/zvac017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 12/29/2022]
Abstract
AIMS Cognitive decline is prevalent among patients with cardiovascular disease (CVD). Cognitive measurement has been considered as a standard assessment for secondary prevention; however, standard cognitive tests are sometimes infeasible due to time constraints. This study aimed to examine the association between the Rapid Dementia Screening Test (RDST), a brief screening tool for cognitive function, and clinical events in elderly patients with CVD. METHODS AND RESULTS This retrospective cohort study included 140 hospitalized patients with CVD who participated in inpatient cardiac rehabilitation (median age, 75 years; male, 67%). Cognitive function for each patient was assessed using the RDST and Montreal Cognitive Assessment (MoCA), a standard test of mild cognitive impairment. The clinical events assessed as outcomes included all-cause mortality and unplanned rehospitalization. Receiver-operating characteristic (ROC) curve analysis showed similar predictive accuracy for the study outcome (P = 0.337) between the RDST [area under the curve, 0.651; 95% confidence interval (CI), 0.559-0.743] and MoCA (0.625; 0.530-0.720). The ROC analysis identified a cut-off value of 9 points for the RDST (sensitivity, 77.8%; specificity, 50.5%). Patients with RDST ≤9 showed a poor survival rate compared with those with ≥10 points (log-rank test, P = 0.002; hazard ratio, 2.94, 95% CI, 1.46-5.94). This result was consistent even after adjusting for potential confounders. CONCLUSION The RDST was associated with clinical events in elderly patients with CVD and its predictive capability was comparable with that of MoCA, a standard cognitive test. The RDST may be useful in CVD as an alternative screening tool for cognitive decline.
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Affiliation(s)
- Takuji Adachi
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-minami, Higashi-ku, Nagoya 461-8673, Japan.,Department of Rehabilitation, Nagoya Ekisaikai Hospital, 4-66 Syonen-cho, Nakagawa-ku, Nagoya 454-8502, Japan
| | - Yuki Tsunekawa
- Department of Rehabilitation, Nagoya Ekisaikai Hospital, 4-66 Syonen-cho, Nakagawa-ku, Nagoya 454-8502, Japan
| | - Akihito Matsuoka
- Department of Rehabilitation, Nagoya Ekisaikai Hospital, 4-66 Syonen-cho, Nakagawa-ku, Nagoya 454-8502, Japan
| | - Daisuke Tanimura
- Department of Cardiology, Nagoya Ekisaikai Hospital, 4-66 Syonen-cho, Nakagawa-ku, Nagoya 454-8502, Japan
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Ye S, Huynh Q, Potter EL. Cognitive Dysfunction in Heart Failure: Pathophysiology and Implications for Patient Management. Curr Heart Fail Rep 2022. [PMID: 35962923 DOI: 10.1007/s11897-022-00564-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/07/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE OF REVIEW There is increasing recognition of the prevalence and impact of cognitive dysfunction (CD) in heart failure (HF) patients. This contemporary review appraises the evidence for epidemiological association, direct pathophysiological links and emerging pharmacological and non-pharmacological interventions. Furthermore, we present evidence for care models that aim to mitigate the morbidity and poor quality of life associated with these dual processes and propose future work to improve outcomes. RECENT FINDINGS CD disproportionately affects heart failure patients, even accounting for known comorbid risk factors, and this may extend to subclinical left ventricular dysfunction. Neuroimaging studies now provide evidence of anatomical and functional differences which support previously postulated mechanisms of reduced cerebral blood flow, micro-embolism and systemic inflammation. Interventions such as multidisciplinary ambulatory HF care, education and memory training improve HF outcomes perhaps to a greater degree in those with comorbid CD. Additionally, optimisation of standard heart failure care (cardiac rehabilitation, pharmacological and device therapy) may lead to additional cognitive benefits. Epidemiological, neuroimaging and intervention studies provide evidence for the causal association between HF and CD, although evidence for Alzheimer's dementia is less certain. Specific reporting of cognitive outcomes in HF trials and evaluation of targeted interventions is required to further guide care provision.
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Niu Q, Liu W, Wang F, Tian L, Dong Y. The Utility of Cognitive Screening in Asian Patients With Heart Failure: A Systematic Review. Front Psychiatry 2022; 13:930121. [PMID: 35911251 PMCID: PMC9329604 DOI: 10.3389/fpsyt.2022.930121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 06/15/2022] [Indexed: 11/23/2022] Open
Abstract
Background The prevalence of undiagnosed cognitive impairment in patients with heart failure is alarmingly high in Asia. There is still no consensus on cognitive screening tools to detect cognitive impairment in the Asian heart failure population. The clinical implications based on our systematic review may help to improve cognitive screening practice for patients with heart failure in Asia. Methods This review is registered in the PROSPERO (CRD42021264288). Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, we searched PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature, Scopus, the Web of Science, PsycINFO, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, and Wanfang Data in English and Chinese literatures concerning heart failure and cognitive impairment. Results The search yielded 21 eligible studies. Only in five studies, cognitive brief tests, including the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), and the Mini-Cog, were used as cognitive screening tools for Asian patients with heart failure. In the rest 16 studies, brief cognitive tests were used as screening tools for global cognition. Only one study validated screening tests against a gold standard formal neuropsychological assessment test battery. Among these studies, patients with heart failure tended to perform worse than patients without heart failure. The presence of cognitive impairment in patients with heart failure is associated with poorer self-care, quality of life, and hospital readmission. Conclusion Brief cognitive tests have been used in Asian patients with heart failure and these tests are frequently used as a measure of global cognitive function for cognitive screening. However, validating brief cognitive tests against a gold standard formal neuropsychological assessment in Asian patients with heart failure is lacking. Future studies need to address methodological issues to validate cognitive screening measures in a larger population of Asian patients with heart failure.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/.
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Affiliation(s)
- Qi Niu
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - WeiHua Liu
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | | | - LiYa Tian
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - YanHong Dong
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Yap NLX, Kor Q, Teo YN, Teo YH, Syn NL, Mance Evangelista LK, Tan BY, Lin W, Yeo LL, Kong WK, Chong YF, Wong RC, Poh KK, Yeo TC, Sharma VK, Chai P, Chan MY, Goh FQ, Sia CH. Prevalence and Incidence of Cognitive Impairment and Dementia in Heart Failure - A Systematic Review, Meta-Analysis and Meta-Regression. Hellenic J Cardiol 2022; 67:48-58. [PMID: 35839985 DOI: 10.1016/j.hjc.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/14/2022] [Accepted: 07/07/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The burden of cognitive impairment in HF patients is significant and leads to longer hospital stay, higher readmission rates, and increased mortality. This review seeks to synthesize the available studies to determine the prevalence and incidence of cognitive impairment and dementia in HF patients. METHODS PubMed, Embase, PsychoINFO and Cochrane databases were systematically searched from their inception through to 3 May 2021. Study and population characteristics, total patients with HF, prevalence of cognitive impairment and dementia in HF patients and cognitive assessment tool were abstracted by two reviewers. RESULTS In heart failure patients, overall prevalence for cognitive impairment and dementia was 41.42% (CI) and 19.79% (dementia) respectively. We performed a meta-regression analysis which demonstrated that the risk of cognitive impairment and dementia increased with age. DISCUSSION Further research should investigate whether HF accelerates the rate of cognitive decline and the progression of dementia.
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Affiliation(s)
- Nicole Li Xian Yap
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228
| | - Qianyi Kor
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228
| | - Yao Neng Teo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228
| | - Yao Hao Teo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228
| | - Nicholas L Syn
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228
| | - Lauren Kay Mance Evangelista
- Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Benjamin Yq Tan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Division of Neurology, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074
| | - Weiqin Lin
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Leonard Ll Yeo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Division of Neurology, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074
| | - William Kf Kong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Yao Feng Chong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Division of Neurology, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074
| | - Raymond Cc Wong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Kian Keong Poh
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Tiong-Cheng Yeo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Vijay Kumar Sharma
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Division of Neurology, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074
| | - Ping Chai
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Mark Y Chan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Fang Qin Goh
- Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Ching-Hui Sia
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228.
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Saito H, Yamashita M, Endo Y, Mizukami A, Yoshioka K, Hashimoto T, Koseki S, Shimode Y, Kitai T, Maekawa E, Kasai T, Kamiya K, Matsue Y. Cognitive impairment measured by Mini-Cog provides additive prognostic information in elderly patients with heart failure. J Cardiol 2020; 76:350-356. [DOI: 10.1016/j.jjcc.2020.06.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/31/2020] [Accepted: 06/07/2020] [Indexed: 12/12/2022]
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Futami S, Ishikawa J, Jubishi C, Shimizu R, Murata T, Aoyama R, Harada K. Prevalence and Determinants of Cognitive Impairment in Elderly Patients With Heart Failure - Pilot Study in a Geriatric Hospital. Circ Rep 2020; 2:265-270. [PMID: 33693240 PMCID: PMC7925315 DOI: 10.1253/circrep.cr-19-0115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background:
Elderly patients admitted to hospital with heart failure (HF) often have cognitive impairment, but the association between these conditions is unclear. Methods and Results:
We enrolled 43 patients admitted to a geriatric hospital with HF. We evaluated echocardiography, Mini Mental State Examination (MMSE), and extracellular water/total body water (ECW/TBW) ratio (Inbody S10). Mean age was 85.1±8.0 years (range, 60–99 years) and 44.2% of the patients were men. Mean MMSE score was 20.5±5.4, with 66.7% of the patients showing cognitive impairment (MMSE ≤23). There was a significant negative correlation of MMSE score with age (r=−0.344, P=0.032), regular alcohol drinking (r=0.437, P=0.007), uric acid level (r=0.413, P=0.010), and ECW/TBW ratio (r=−0.437, P=0.007). On stepwise regression analysis including these covariates, MMSE score was significantly associated with the ECW/TBW ratio (β=0.443, P=0.009). When several echocardiography parameters (i.e., end-diastolic left ventricular volume, r=0.327, P=0.048; left atrial volume index, r=−0.411, P=0.012; and transmitral inflow A wave velocity, r=−0.625, P=0.001) were added to the model, MMSE score was found to be related to the A wave (P=0.001) and to atrial volume index (P=0.015), which are measures of diastolic function. Conclusions:
In elderly patients with HF, cognitive function might be influenced by body water distribution and diastolic heart function.
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Affiliation(s)
- Shutaro Futami
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Department of Cardiology Tokyo Japan
| | - Joji Ishikawa
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Department of Cardiology Tokyo Japan
| | - Chihiro Jubishi
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Department of Cardiology Tokyo Japan
| | - Ruri Shimizu
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Department of Cardiology Tokyo Japan
| | - Teppei Murata
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Department of Cardiology Tokyo Japan
| | - Rie Aoyama
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Department of Cardiology Tokyo Japan
| | - Kazumasa Harada
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Department of Cardiology Tokyo Japan
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