This article is more than 5 years old. Information may no longer be current.
Link between ejection fraction and verbal memory observed
Festa J. Arch Neurol. 2011;68:1021-1026.
Click Here to Manage Email Alerts
In a population of patients with HF and low ejection, those aged at least 63 years had significantly reduced verbal memory compared with younger patients, new study results indicated.
The retrospective study, appearing in the Archives of Neurology, pooled data on 207 patients with HF (age range, 17-72 years) who were given standardized tests to assess memory function. Joanne R. Festa, PhD, and colleagues stratified patients by age and compared memory function in those with ejection fractions of less than 30% with those with ejection fractions of 30% or higher.
According to univariate analyses, the following variables significantly correlated with low memory composite score or the mean of the summed visual and verbal memory scores: self-rated depressive symptoms, low attention, low executive functioning (P<.001 for all three), nonwhite race/ethnicity (P=.003), less than a high school education (P=.01), history of hypertension (P=.03) and use of benzodiazepines (P=.05).
After adjusting for significant covariates, Festa and colleagues found a significant association between age and ejection fraction with respect to memory function. Specifically, patients aged at least 63 years had a decline in memory function when ejection fraction was less than 30% (P<.02), an observation not witnessed in those aged 62 years and younger with low ejection fractions.
Also of note, verbal recall memory (P=.02) and verbal recognition (P=.05) were most affected by a low ejection fraction among patients aged at least 63 years.
“Based on conservative estimates, cognitive dysfunction due to HF may affect at least 1 million patients with HF in the United States. … Identifying older patients with HF who are at risk for greater cognitive dysfunction can improve treatment outcomes and may ultimately reduce the use of medical services,” the researchers wrote.
The article by Festa and colleagues provides clinically relevant information. These investigators found a significant interaction between low ejection fraction (<30%) and worse memory in patients with HF older than 63 years. Although the study was not designed to investigate the mechanism by which low ejection fraction affects memory, it has important clinical implications. Because the average age of patients with HF due to left ventricular systolic dysfunction is older than 70 years, the findings of the study apply to the majority of patients with systolic HF. As indicated by the investigators, impaired memory has an important detrimental effect due to its impact on self-management of HF secondary to reduced compliance with diet and medication use as well as with keeping medical appointments. This creates an increasing burden on the family and, not surprisingly, is associated with increasing morbidity and mortality.
– Uri Elkayam, MD
Cardiology Today Editorial Board member
Disclosure: Dr. Elkayam reports no relevant financial disclosures.
 |
Follow CardiologyToday.com on Twitter. |