Cognitive impairment and heart failure: systematic review and meta-analysis

Cannon, J. A., Moffitt, P., Perez-Moreno, A. C., Walters, M. R. , Broomfield, N. M., McMurray, J. J.V. and Quinn, T. J. (2017) Cognitive impairment and heart failure: systematic review and meta-analysis. Journal of Cardiac Failure, (doi: 10.1016/j.cardfail.2017.04.007) (PMID:28433667)

Abstract

Cognitive impairment and dementia are associated with a range of cardiovascular conditions including hypertension, coronary artery disease and atrial fibrillation. We aimed to describe the association with heart failure, summarising published data to give estimates around prevalence, incidence and relative risk of cognitive impairment/dementia in heart failure. We searched multidisciplinary databases including MEDLINE (OVID), EMBASE (OVID), CINAHL (EBSCO), PsychINFO (EBSCO), Web of Science (Thomson Reuters) and CENTRAL (Cochrane Library) from inception until 31(st) May 2015. All relevant studies looking at cognitive impairment/dementia in heart failure were included. Studies were selected by two independent reviewers using pre-specified inclusion/exclusion criteria. Where data allowed we performed meta-analysis and pooled results using random effects models. From 18,000 titles 37 studies were eligible (n=8411 participants). Data from 4 prospective cohorts (n= 2513 participants) suggest greater cognitive decline in heart failure compared to non-heart failure over the longer term. These data were not suitable for meta-analysis. In case-control studies describing those with and without heart failure (n=4 papers, 1414 participants) the odds ratio for cognitive impairment in the heart failure population was 1.67 (95% confidence interval 1.15 -2.42). Prevalence of cognitive impairment in heart failure cohorts (n=26 studies, 4176 participants) was 43% (95% confidence interval 30-55%). This review suggests a substantial proportion of patients with heart failure have concomitant cognitive problems. This has implications for planning treatment and services. These data do not allow us to comment on causation and further work is needed to describe the underlying pathophysiology.

• Item Type: Articles
• Keywords: Meta-analysis.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Perez, Mrs Ana and Quinn, Professor Terry and Broomfield, Dr Niall and McMurray, Professor John and Walters, Professor Matthew and Cannon, Dr Jane
• Authors: Cannon, J. A., Moffitt, P., Perez-Moreno, A. C., Walters, M. R., Broomfield, N. M., McMurray, J. J.V., and Quinn, T. J.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Journal of Cardiac Failure
• Publisher: Elsevier
• ISSN: 1071-9164
• ISSN (Online): 1532-8414
• Published Online: 19 April 2017
• Copyright Holders: Copyright © 2017 Elsevier
• First Published: First published in Journal of Cardiac Failure 2017
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher