Heart Failure Patients Versus Healthy Controls: Comparison of Cognitive and Prospective Memory Function

Background: Heart failure (HF) patients are susceptible to cognitive impairment including prospective memory (PM), increasing vulnerability for adverse health outcomes. Aim: To compare cognitive function and PM performance between HF patients and a matched sample of healthy controls. Methods: 38 HF patients and 17 controls underwent comprehensive baseline cognitive and PM assessments using validated neuropsychological tests. The Montreal Cognitive Assessment (MOCA) and Addenbrooke's Cognitive Examination - Revised (ACER) assessed general cognitive function. The Memory for Intentions Task (MIST) assessed PM. The Hopkins Verbal Learning Test (HVLT) assessed verbal learning. Mean, standard deviation or proportions were compared using t-tests or Chi square tests as appropriate. Results: HF patients and healthy controls were matched for age (63.9 ±13.5 years vs 67.0 ±7.7 years, p=0.38). Patients demonstrated significantly poorer performance on general cognitive function compared with healthy controls (MOCA score: 25.9 ±2.4 vs. 27.7 ±1.9, p<0.01; ACE-R score: 91.1 ±5.3 vs 95.2 ±4.0, p<0.01). The proportion of patients who successfully completed the 5 MOCA visuospatial/executive tasks was particularly low compared with controls (24% vs 77%, p<0.01). Patients also performed more poorly on verbal learning (HVLT score: 24.3 ±5.0 vs 28 ±4.1, p=0.01). Patients had worse performance on PM (MIST score: 30.7 ±9.6 vs 34.7 ±6.9, p=0.14), although statistically non-significant this difference represents a medium effect size (Cohen's d=0.5). Conclusion: HF patients have impaired cognitive functioning and possible deficits in PM functioning compared to healthy controls. This may impact on daily functioning with implications for clinical practice and research investigating the potential benefits of cognitive training.