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Cognitive test results are associated with mortality and rehospitalization in heart failure : Swedish prospective cohort study

Holm, Hannes LU ; Bachus, Erasmus LU ; Jujic, Amra LU ; Nilsson, Erik D LU ; Wadström, Benjamin ; Molvin, John LU ; Minthon, Lennart LU ; Fedorowski, Artur LU orcid ; Nägga, Katarina LU and Magnusson, Martin LU orcid (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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Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and
organization
publishing date
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
  • pmid:32810367
  • scopus:85089525362
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
2024-06-12 19:20:06
@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 &lt; 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}},
}