Objective: assessment of cognitive impairment (CI) in «fragile» patients with arterial hypertension (AH) and chronic heart failure (CHF).Materials and methods: the study involved 168 patients with hypertension and senile asthenia syndrome (SSA) over the age of 80 years. Taking into account the presence of CHF, all patients were ranked into two groups: group 1 – patients with hypertension, CSA and CHF (n=84), group 2 – patients with hypertension, CSA without CHF (n=84). Cognitive functions (CF) were assessed by neuropsychological testing using the MMSE short scale, which determines the patient’s mental status.Results: anemia (p=0.033), AF (p=0.003) and type 2 diabetes (p=0.042) were more common in group 1 patients, and higher BMI (p<0.001) in group 2. CI was recorded in 95.2% of patients (50.6% non-dementic CI, 48.8% mild dementia, and 0.6% moderate). In patients with CAS, AH and CHF, mild dementia was more often detected (p=0.005), and in patients without CHF, non-dementic CI was more often detected (p=0.000). In addition, in the 1st group of patients, a decrease in concentration of attention (p=0.036), and spatial and visual memory (p=0.048) was more often recorded in comparison with patients without CHF. Women of the 1st group, in comparison with men, more often had a mild degree of dementia (p=0.050). In men, there was a clear trend towards a more frequent occurrence of non-dementic CI (p=0.068). In addition, in the same group, 2.3% of women had moderate dementia, and 7.5% of men had no CI at all. Among patients with SSA and AH, but without CHF, there were no gender differences in the incidence of cognitive impairment.Conclusions: the obtained results of the study indicate the adverse effect of CHF on cognitive functions in senile patients with AH and CAS. Timely and optimal treatment of not only hypertension, but also CHF will reduce the risk of development and severity of cognitive impairment in such patients.