Effects of cumulative cognitive function within 1-year of discharge on subsequent mortality among patients hospitalized for acute heart failure: A nationwide prospective cohort study

Wei Wang; Yue Peng; Guangda He; Yan Li; Yanchen Liu; Lubi Lei; Jingkuo Li; Boxuan Pu; Yanwu Yu; Lihua Zhang; Yuanlin Guo

doi:10.1093/gerona/glad288

Effects of cumulative cognitive function within 1-year of discharge on subsequent mortality among patients hospitalized for acute heart failure: A nationwide prospective cohort study

J Gerontol A Biol Sci Med Sci. 2024 Jan 3:glad288. doi: 10.1093/gerona/glad288. Online ahead of print.

Authors

Wei Wang¹, Yue Peng¹, Guangda He¹, Yan Li¹, Yanchen Liu², Lubi Lei¹, Jingkuo Li¹, Boxuan Pu¹, Yanwu Yu¹, Lihua Zhang¹, Yuanlin Guo³

Affiliations

¹ National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
² National Clinical Research Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Guangdong, China.
³ Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

PMID: 38170569
DOI: 10.1093/gerona/glad288

Abstract

Backgrounds: To examine the association between cumulative cognitive function and subsequent mortality among patients hospitalized for acute heart failure (AHF).

Methods: Based on a prospective cohort of patients hospitalized for AHF, cognitive function was measured by using Mini-Cog test at admission, 1- and 12-month following discharge. Cumulative cognitive function was interpreted by cumulative Mini-Cog score and cumulative times of cognitive impairment. Outcomes included subsequent all-cause and cardiovascular mortality.

Results: 1454 patients hospitalized for AHF with median follow-up of 4.76 (interquartile range [IQR]: 4.18-5.07) years were included. Tertile 1 of cumulative Mini-Cog score had the highest risk of all-cause (hazard ratio [HR]: 1.52, 95% confidence interval [CI]: 1.14-2.03) and cardiovascular mortality (HR: 1.40, 95% CI: 1.02-1.93) compared with Tertile 3; patients with ≥ 2 times of cognitive impairment had the highest risk of all-cause (HR: 1.34, 95% CI: 1.03-1.73) and cardiovascular mortality (HR: 1.25, 95% CI: 0.93-1.67) compared with patients without any cognitive impairment. Cumulative Mini-Cog score provided the highest incremental prognostic ability in predicting all-cause (C-statistics: 0.64, 95% CI: 0.61-0.66) and cardiovascular mortality (C-statistics: 0.63, 95% CI: 0.60-0.67) risk on the basis of Get With The Guidelines-Heart Failure score.

Conclusion: Poor cumulative cognitive function was associated with increased risk of subsequent mortality and provided incremental prognostic ability for the outcomes among patients with AHF. Longitudinal assessment and monitoring of cognitive function among patients with AHF would be of great importance in identifying patients at greater risk of self-care absence for optimizing personal disease management in clinical practice.

Keywords: Cognitive function; Cumulative exposure; Heart failure; Mortality; Prospective cohort study.