Cognitive test results are associated with mortality and rehospitalization in heart failure : Swedish prospective cohort study
(2020) In ESC Heart Failure 7(5). p.2948-2955- Abstract
AIMS: We aimed to search for associations between cognitive test results with mortality and rehospitalization in a Swedish prospective heart failure (HF) patient cohort.
METHODS AND RESULTS: Two hundred and eighty-one patients hospitalized for HF (mean age, 74 years; 32% women) were assessed using cognitive tests: Montreal Cognitive Assessment (MoCA), A Quick Test of Cognitive speed, Trail Making Test A, and Symbol Digit Modalities Test. The mean follow-up time censored at rehospitalization or death was 13 months (interquartile range, 14) and 28 months (interquartile range, 29), respectively. Relations between cognitive test results, mortality, and rehospitalization risk were analysed using multivariable Cox regression model... (More)
AIMS: We aimed to search for associations between cognitive test results with mortality and rehospitalization in a Swedish prospective heart failure (HF) patient cohort.
METHODS AND RESULTS: Two hundred and eighty-one patients hospitalized for HF (mean age, 74 years; 32% women) were assessed using cognitive tests: Montreal Cognitive Assessment (MoCA), A Quick Test of Cognitive speed, Trail Making Test A, and Symbol Digit Modalities Test. The mean follow-up time censored at rehospitalization or death was 13 months (interquartile range, 14) and 28 months (interquartile range, 29), respectively. Relations between cognitive test results, mortality, and rehospitalization risk were analysed using multivariable Cox regression model adjusted for age, sex, body mass index, systolic blood pressure, atrial fibrillation, diabetes, smoking, educational level, New York Heart Association class, and prior cardiovascular disease. A total of 80 patients (29%) had signs of cognitive impairment (MoCA score < 23 points). In the fully adjusted Cox regression model using standardized values per 1 SD change of each cognitive test, lower score on MoCA [hazard ratio (HR), 0.75; confidence interval (CI), 0.60-0.95; P = 0.016] and Symbol Digit Modalities Test (HR, 0.66; CI, 0.48-0.90; P = 0.008) yielded significant associations with increased mortality. Rehospitalization risk (n = 173; 62%) was significantly associated with lower MoCA score (HR, 0.84; CI, 0.71-0.99; P = 0.033).
CONCLUSIONS: Two included cognitive tests were associated with mortality in hospitalized HF patients, independently of traditional risk factors. In addition, worse cognitive test scores on MoCA heralded increased risk of rehospitalization.
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- author
- Holm, Hannes LU ; Bachus, Erasmus LU ; Jujic, Amra LU ; Nilsson, Erik D LU ; Wadström, Benjamin ; Molvin, John LU ; Minthon, Lennart LU ; Fedorowski, Artur LU ; Nägga, Katarina LU and Magnusson, Martin LU
- organization
- publishing date
- 2020-10
- type
- Contribution to journal
- publication status
- published
- subject
- in
- ESC Heart Failure
- volume
- 7
- issue
- 5
- pages
- 8 pages
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- scopus:85089525362
- pmid:32810367
- ISSN
- 2055-5822
- DOI
- 10.1002/ehf2.12909
- project
- Prediction, Prevention and Treatment of Progressing Heart Failure and Coincident Cognitive Impairment
- language
- English
- LU publication?
- yes
- additional info
- © 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.
- id
- 0abf0b46-d58f-4743-af75-8f39e4a06d36
- date added to LUP
- 2020-08-24 13:47:04
- date last changed
- 2024-09-20 03:42:25
@article{0abf0b46-d58f-4743-af75-8f39e4a06d36, abstract = {{<p>AIMS: We aimed to search for associations between cognitive test results with mortality and rehospitalization in a Swedish prospective heart failure (HF) patient cohort.</p><p>METHODS AND RESULTS: Two hundred and eighty-one patients hospitalized for HF (mean age, 74 years; 32% women) were assessed using cognitive tests: Montreal Cognitive Assessment (MoCA), A Quick Test of Cognitive speed, Trail Making Test A, and Symbol Digit Modalities Test. The mean follow-up time censored at rehospitalization or death was 13 months (interquartile range, 14) and 28 months (interquartile range, 29), respectively. Relations between cognitive test results, mortality, and rehospitalization risk were analysed using multivariable Cox regression model adjusted for age, sex, body mass index, systolic blood pressure, atrial fibrillation, diabetes, smoking, educational level, New York Heart Association class, and prior cardiovascular disease. A total of 80 patients (29%) had signs of cognitive impairment (MoCA score < 23 points). In the fully adjusted Cox regression model using standardized values per 1 SD change of each cognitive test, lower score on MoCA [hazard ratio (HR), 0.75; confidence interval (CI), 0.60-0.95; P = 0.016] and Symbol Digit Modalities Test (HR, 0.66; CI, 0.48-0.90; P = 0.008) yielded significant associations with increased mortality. Rehospitalization risk (n = 173; 62%) was significantly associated with lower MoCA score (HR, 0.84; CI, 0.71-0.99; P = 0.033).</p><p>CONCLUSIONS: Two included cognitive tests were associated with mortality in hospitalized HF patients, independently of traditional risk factors. In addition, worse cognitive test scores on MoCA heralded increased risk of rehospitalization.</p>}}, author = {{Holm, Hannes and Bachus, Erasmus and Jujic, Amra and Nilsson, Erik D and Wadström, Benjamin and Molvin, John and Minthon, Lennart and Fedorowski, Artur and Nägga, Katarina and Magnusson, Martin}}, issn = {{2055-5822}}, language = {{eng}}, number = {{5}}, pages = {{2948--2955}}, publisher = {{John Wiley & Sons Inc.}}, series = {{ESC Heart Failure}}, title = {{Cognitive test results are associated with mortality and rehospitalization in heart failure : Swedish prospective cohort study}}, url = {{http://dx.doi.org/10.1002/ehf2.12909}}, doi = {{10.1002/ehf2.12909}}, volume = {{7}}, year = {{2020}}, }