检查注意力、执行功能和记忆，以预测收缩性心力衰竭成人的死亡风险。
Examination of attention, executive function, and memory as predictors of mortality risk in adults with systolic heart failure.
机构信息
Department of Psychological Sciences, Kent State University, USA.
Centers for Behavioral and Preventive Medicine, The Miriam Hospital, USA.
出版信息
Eur J Cardiovasc Nurs. 2019 Dec;18(8):729-735. doi: 10.1177/1474515119863182. Epub 2019 Jul 25.
BACKGROUND
The prevalence and impact of cognitive impairment in heart failure is increasingly recognized. Converging evidence points to global cognitive function as predictive of prognosis in adults with heart failure when assessed with screening tools. Additional work is needed to understand which domains of cognitive function are most relevant for prognosis.
AIMS
The present study sought to examine associations between domains of cognitive function and mortality risk in adults with heart failure.
METHODS
In the present prospective, observational cohort study, global cognitive function, attention, executive function, and memory were assessed by means of a comprehensive neuropsychogical battery in adults with systolic heart failure. Mortality data were obtained from the National Death Index (median follow-up 2.95 years). Relationships among each cognitive domain and mortality were assessed with Cox regression. Covariates included age, sex, heart failure severity, comorbidity and depressive symptoms.
RESULTS
Participants were 325 patients with systolic heart failure with a mean age of 68.6 years (59% men, 73% Caucasian). Following covariate adjustment, better global cognitive function, attention, and executive function were related to decreased mortality risk.
CONCLUSIONS
Future research is needed to clarify the underlying mechanisms of the association between cognitive impairment and mortality.
背景
认知障碍在心力衰竭中的普遍性和影响日益受到重视。越来越多的证据表明，当使用筛查工具评估时，全球认知功能对心力衰竭成人的预后具有预测作用。需要进一步研究以了解认知功能的哪些领域与预后最相关。
目的
本研究旨在探讨认知功能领域与心力衰竭成人死亡风险之间的关系。
方法
在本前瞻性观察队列研究中，通过综合神经心理学测试评估了收缩性心力衰竭成人的整体认知功能、注意力、执行功能和记忆力。通过国家死亡指数（中位随访 2.95 年）获得死亡率数据。使用 Cox 回归评估每个认知域与死亡率之间的关系。协变量包括年龄、性别、心力衰竭严重程度、合并症和抑郁症状。
结果
参与者为 325 名患有收缩性心力衰竭的患者，平均年龄为 68.6 岁（59%为男性，73%为白种人）。在调整协变量后，更好的整体认知功能、注意力和执行功能与降低的死亡率风险相关。
结论
需要进一步的研究来阐明认知障碍与死亡率之间关联的潜在机制。
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