Cognitive impairment is an under-recognized component in HF. Not only do clinicians fail to recognize it but it may have a substantial impact on the ability of patients to perform self-care and stay out of the hospital?
An impedance cardiograph is a simple noninvasive point-of -care device for assessing heart failure in the clinical setting. A pertinent publication is attached. I can provide more data if desired.
Article Using Impedance Cardiography to Assess Left Ventricular Syst...
Many clinical studies have focused on the evaluation of screening tools to assess cognitive impairment in patients with heart failure (HF), yet there's no consensus on standard or specific set of tests or questionnaires to be applied. The pattern of cognitive deficits among people with HF, is similar to those found among patients with vascular cerebral impairment (i.e. attention, psychomotor speed, and executive impairment in particular, memory impairment).
Davis K and Allen J, in a review of litterature (Heart Lung 2013) published from 2000 to 2011 (23 studies) identified 7 screening instruments amongst which the Montreal Cognitive Assessment (MoCA) appeared to be a suitable screening tool in this population.
A paper from Cameron J et al. (European journal of Heart Failure, dec 2013) is newly published on this topic too.
Best regards
A fully agree that this is an important but underestimated problem. Moreover, it is not entirely clear in what way the two are influences each other. This is why we participate in a multicentre research project in the NL, where patients from three different cohorts (vascular cognitive impairment, carotid stenosis, heart failure) are screened (MRI, biomarkers and clincally) with a similar protocol.
In clinical practice, we are setting up a comprehensive screening of heart failure patients with MoCA, but also link this with compliance of the patients with medication and "understanding heart failure" using tele-eduction. I think that more should be done in this regard as the impact on care, quality of life, but also outcome and costs is much bigger than generally thought. Any initiatives to combine efforts on this in clinical practice is highly welcome.
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