How to identify and help heart failure patients who show signs of cognitive impairment

The authors of the statement highlighted ways for medical teams to identify heart failure patients who may be experiencing various symptoms of cognitive impairment. The first method of finding these patients is probably the simplest and requires no additional technology. Pay close attention to how the patient acts and communicates.

“Gaps or errors in patients’ self-reported medical history may indicate short-term memory loss and associated cognitive impairment,” the authors wrote. “Forgotten doses or medication errors may indicate cognitive impairment. Nonadherence does not necessarily represent a clear reluctance or indifference to take the medication as directed; in fact, Inattention may be due to cognitive impairment. Declining health literacy, especially if the decline occurs over time, may be a clue to cognitive impairment. Finally, instrumental activities of daily living Emerging deficits in (manifested as increased dependence on others for assistance with various tasks, such as managing finances) may indicate cognitive impairment.

The group says that if clinicians detect any of these signals, they should investigate the situation further. Several “formal screening tools” also exist to help identify patients with cognitive impairment. These include the Mini-Cog Test, the Mini-Mental Status Examination, the Montreal Cognitive Assessment, and the St. Louis University Mental Status Examination.

“When cognitive impairment is suspected, it may be reasonable to consult experts in imaging and neuropsychological testing who can provide a definitive diagnosis and characterization,” the authors write. There is. “Neuropsychological tests typically test multiple areas such as intelligence, memory, language, executive function, and visuospatial function. They are administered by a professional neuropsychologist and can last up to 2 to 4 hours. ”

Managing a patient’s medication, including in some cases deprescribing, is one way clinicians can help heart failure patients who show signs of cognitive decline. Suggesting exercise and enlisting the help of a patient’s friends and family are other ways to help patients receive the best possible care and live a fulfilling life.

Click here to read the full scientific statement Journal of Heart Failure.

“HFSA’s top priority is improving heart failure treatment,” HFSA President James C. Huang, M.D., said in a statement from the organization. “Thanks to the work of this co-author of his HFSA Scientific Statement, cognitive impairment has become a larger part of the overall care of patients with heart failure. Increased interest in this important comorbidity.” This allows patients to receive comprehensive care.”