Combined Influence of Depression and Physical Frailty on Cognitive Impairment in Patients with Heart Failure

Abstract

Cognitive impairment is a prevalent condition and important barrier to self-care behaviors in patients with heart failure (HF). HF patients with depression or physical frailty are more likely to have reduced cognitive function. However, it remains unclear if combined depression and physical frailty increased the risk of cognitive impairments among HF populations. This study aimed to identify the influence of combined depression and physical frailty on cognitive impairments in HF. This cross-sectional study was included 289 patients with HF in outpatient cardiology clinics at a tertiary care university hospital in Cheonan, South Korea. We obtained patients’ characteristics including depression, physical frailty, and cognitive function with Korean validated tools using a face-to-face interview. The prevalence rate of cognitive impairment was approximately 27.3% in HF outpatients. We found that the combined influence of depression and physical frailty increased the risk of cognitive impairments in both unadjusted (odds ratio (OR) 4.360; 95% confidence interval (CI) (2.113, 8.994)) and adjusted models (OR 3.545; 95% CI (1.448, 8.681)). Our findings highlight that healthcare professionals need to be more aware of the vulnerable population who suffer from both depression and physical frailty at the same time. Future prospective studies should examine the causal relationships among depression, physical frailty and cognitive impairment during the HF illness trajectories.

Brain Imaging Changes and Related Risk Factors of Cognitive Impairment in Patients With Heart Failure

“…A total of three studies ( 23 , 62 , 64 ) indicated that depression was related to the impairment of memory function, attention, executive ability, language ability, and other cognitive fields in HF patients. In addition, the combined effects of depression and physical weakness increased the risk of CI in HF patients ( 58 ). However, four studies had found opposite results.…”

Sintomas depressivos e fragilidade física em pessoas idosas: revisão integrativa

“…Considerando a relação entre os sintomas depressivos e a fragilidade física, em alguns estudos foram relatados desfechos negativos à saúde da pessoa idosa decorrente destas condições quando agem de forma associada. Entre os desfechos, destacamse: comprometimento cognitivo 18,23,24 , limitação das atividades 26 , pior autoavaliação da saúde 19,21 , incapacidade funcional para ABVD e atividades instrumentais da vida diária (AIVD) 19,29 , quedas e internações 18,19,27 .…”

Integrating assessment of cognitive status in elderly cardiovascular care

“…Among community‐based older adults with HF, cognitive impairment has complex cross‐sectional associations with physical frailty, sleep disorders, and mood disorders including depression, anxiety, and hopelessness . Cognitive impairment has been linked to a variety of poor outcomes including worse health‐related quality of life, increased spousal/caregiver distress, increased disability, worse cardiovascular outcomes at 180 days, and increased mortality risk .…”

“…11 Patel et al 12 Among community-based older adults with HF, cognitive impairment has complex cross-sectional associations with physical frailty, sleep disorders, and mood disorders including depression, anxiety, and hopelessness. [14][15][16][17] Cognitive impairment has been linked to a variety of poor outcomes including worse health-related quality of life, increased spousal/caregiver distress, increased disability, worse cardiovascular outcomes at 180 days, and increased mortality risk. 18,19 A common link, which has immense practical implications for clinicians caring for older adults with HF, is that cognitive impairment in this population is associated with worse self-management, self-care, and self-confidence.…”