Cognitive function of elderly and senile patients on the background of long-term pharmacotherapy of chronic heart failure with low ejection fraction
Background: Chronic heart failure (CHF) is associated with a high risk of developing psycho-emotional, mnestic disorders and impaired cognitive function (CF). However, most clinical studies do not include older patients. The aim of the study: To study the effect of long-term (12 months) optimal drug therapy (OMT) on CF in elderly and senile patients with CHF with low ejection fraction (CHFrEF). Materials and methods: 93 elderly and senile patients with CHFrEF were examined. Electrocardiography, monitoring of glomerular filtration rate (GFR), testing on the SHOKS scale, 6-minute walk test (T6MX), CF was assessed by the Montreal Cognitive Assessment (MoCA) test and the Mini-mental state examination (MMSE) test. Results: After 12 months of pharmacotherapy in elderly patients with CHFrEF, EF increased to a greater extent (p <0.05), the MoCA test improved (p<0.05). Т6МХ (p<0.05), SHOKS (p<0.05). It was found that the glomerular filtration rate in the group of elderly patients significantly increased by 7.8% (p<0.05), while in the senile group the GFR remained without significant changes. There was a significant correlation between the MoCa test and LV EF (r=0.655, p<0.01), MMSE and LV EF (r=0.527, p<0.01), high correlation between MoCa and GFR (r = 0.765, p<0.001), MMSE and GFR (r=0.671, p<0.001). The predicted level of GFR and the MoCa test was determined as 0.92±0.04 with 95% CI: 0.836-0.995 (p<0.001). The threshold value of GFR at the cut-off point is 86.5 ml/min/1.73 m2. The presence of dementia is predicted when GFR falls below 86.5 ml/min/1.73 m2. The sensitivity and specificity of the method were 75.6% and 88.9%, respectively. Conclusion: Long-term use of OMT in patients with CHFrEF improves myocardial systolic function, increases GFR, which is reflected in the improvement of cognitive function and increased exercise tolerance, the changes are significantly more pronounced in the elderly group, in relation to senile patients.
Osipova OA, Shepel RN, Plaksina KG, et al. Cognitive function of elderly and senile patients on the background of long-term pharmacotherapy of chronic heart failure with low ejection fraction. Research Results in Biomedicine. 2023;9(2): 254-267. Russian. DOI: 10.18413/2658-6533-2023-9-2-0-8
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