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The Prevalence of Cognitive Impairment Among Adults with Incident Heart Failure: The REasons for Geographic and Racial Differences in Stroke (REGARDS) Study.

BACKGROUND: Cognitive impairment (CI) is estimated to be present in 25%-80% of heart failure (HF) patients, but its prevalence at diagnosis is unclear. To improve our understanding of cognition in HF, we determined the prevalence of CI among adults with incident HF in the REGARDS study.

METHODS: REGARDS is a longitudinal cohort study of adults ≥45 years of age recruited from 2003-2007. Incident HF was expert-adjudicated. Cognitive function was assessed with the Six-Item-Screener. The prevalence of CI among those with incident HF was compared to the prevalence of CI among an age, sex, and race-matched cohort without HF.

RESULTS: The 436 participants with incident HF had a mean age of 70.3 years (SD 8.9), 47% were female, and 39% were black. Old age, black race, female gender, less education, and anticoagulation use were associated with CI. The prevalence of CI among participants with incident HF (14.9% [11.7-18.6%]) was similar to the non-HF matched cohort (13.4% [11.6% - 15.4%], p<0.43).

CONCLUSION: 14.9% of adults with incident HF had CI, suggesting that the majority of cognitive decline occurs after HF diagnosis. Increased awareness of CI among newly diagnosed patients, and ways to mitigate it in the context of HF management, are warranted.

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