Gaviria Moises, Pliskin Neil, Kney Adam
Department of Psychiatry, Advocate Christ Medical Center, Oak Lawn, IL, USA.
Congest Heart Fail. 2011 Jul-Aug;17(4):175-9. doi: 10.1111/j.1751-7133.2011.00242.x. Epub 2011 Jul 21.
Cognitive impairment (CI) is a multifaceted entity that entails more than just memory loss. Deficits in other domains, most importantly executive function, can have profound effects on health outcomes in afflicted patients. The prevalence of CI among the heart failure population is exceedingly high, and even higher so among patients with advanced heart failure (AHF). These patients display consistent declines in memory, attention, psychomotor abilities, and executive function. Such deficits interfere with patients' abilities to recognize worsening symptoms, adhere to complex medication regimens, and make sound decisions pertaining to medical care. Regular evaluation of cognitive status using instruments such as the Montreal Cognitive Assessment is a fast, reliable method that allows physicians who treat patients with AHF to anticipate these obstacles to treatment and act accordingly. Referral for more comprehensive neuropsychological evaluation should be considered for patients with unexplained declines from baseline, legal determination of competence, and for heart transplant or ventricular assist device placement candidates.
认知障碍（CI）是一个多方面的问题，不仅仅是记忆力减退。其他领域的缺陷，最重要的是执行功能，会对患病患者的健康结果产生深远影响。心力衰竭人群中CI的患病率极高，在晚期心力衰竭（AHF）患者中甚至更高。这些患者在记忆力、注意力、心理运动能力和执行功能方面持续下降。这些缺陷会干扰患者识别症状恶化、坚持复杂药物治疗方案以及做出有关医疗护理的明智决策的能力。使用蒙特利尔认知评估等工具定期评估认知状态是一种快速、可靠的方法，可让治疗AHF患者的医生预见这些治疗障碍并采取相应行动。对于基线出现不明原因下降、进行法律能力判定以及心脏移植或心室辅助装置植入候选者的患者，应考虑转介进行更全面的神经心理学评估。
