Cognitive Impairment and Self-Care Among Congestive Heart Failure Patients in an Outpatient Clinic

The burden of congestive heart failure (CHF) is the greatest among older adults. Cognition is important for carrying out self-care tasks such as monitoring sodium intake, but little is known about how cognition affects self-care in acutely ill CHF patients. We aimed to assess the association between cognition and self-care in CHF patients from an outpatient diuresis clinic. Cognitive function was measured using the Mini-Mental State Exam (MMSE) and other tests representing 5 cognitive domains. The Self-Care of Heart Failure Index (SCHFI), given to a subset of participants, consisted of 22 questions each scored on an ordinal scale of 1-4 with a total score ranging from 22-88; higher scores indicated better self-care. SCHFI questions were further categorized into maintenance, management and confidence sub-scores. Multiple linear regressions were used to analyze the association between neuropsychological test scores and SCHFI scores. A total of 68 CHF patients had complete SCHFI data, with a mean age of 65.6 years and a mean total SCHFI score of 70.9 points. Nine (13.2%) patients were cognitively impaired (MMSE