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Heart Failure and Cognitive Impairment: The Need for New Management Approach

      The presence of cognitive impairment is well documented in patients with heart failure (HF), with a prevalence ranging between 25% and 75%. HF might lead to cognitive impairment, which is mechanisms include cerebral hypoperfusion and systemic inflammation, thus there are several reasonable reasons to suspect an association between HF and cognitive dysfunction. The cognitive impairment is an important target to disease management of HF, because the treatment of HF is a complex multidrug pharmacological treatment that requires strict adherence. In recent years, mild cognitive impairment (MCI) was described as an intermediate step between normal cognitive function and dementia that make performance of some activities of daily living more difficult than usual (eg, unable to organize medications or appointments without a memory aid or take care of finances) but are not severe enough to impair basic activities of daily living (eg, dressing and eating). Our observational study was demonstrated that MCI, assessed by the Montreal Cognitive Assessment (MoCA), was prevalent among 70% of HF patients, and language and memory function declined among a half of patients. These functions might be associated with self-care behaviors of HF, therefore further studies are needed the impact of MCI on self-management in patients with HF. Moreover, new management approach for MCI should be required to develop the effective HF disease management program in an aging society.
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