Prevalence and Association Between Cognition, Anxiety, and Depression in Patients Hospitalized with Heart Failure

Abstract Background Cognitive impairment, anxiety, and depression are present in patients with heart failure (HF), but their mutual correlation in hospitalized patients is not well established. Objectives The aims of this study were to identify the presence of cognitive impairment and the most affected domain, to investigate possible associations of cognitive impairment with depression and/or anxiety, and to observe whether they correlated with occurrence of readmission within 30 days following hospital discharge. Methods This is a prospective observational study including patients with HF from a private hospital. Psychological distress and cognition were evaluated by the Hospital Anxiety and Depression Scale (HADS) and by the Mini Mental State Exam (MMSE), respectively. Clinical data were obtained from the medical record at the time of inclusion, and outpatient follow-up was performed 30 days after discharge via telephone calls. Results This study included 71 patients (83% men, 75 ± 11 years). Cognitive impairment was present in 53.5% of the patients, and recall memory was the most altered cognitive domain. The proportion of possible/probable anxiety and depression was 21.1% and 34.2% in patients with cognitive impairment, respectively. However, only depression demonstrated association with cognitive impairment (p = 0.018). Cognitive impairment, anxiety, and depression showed no relationship with the occurrence of readmission within 30 days. Conclusions Cognitive impairment and depressive symptoms are prevalent and associated, and recall memory was the most altered cognitive domain in patients hospitalized with HF. However, there was no relationship between these factors and readmission within 30 days.**背景** 心力衰竭（heart failure, HF）患者常合并认知功能损害、焦虑与抑郁症状，但住院患者群体中三者的相互关联尚未得到充分阐明。**目的** 本研究旨在明确心力衰竭住院患者认知功能损害的检出情况及受累最显著的认知域，探究认知功能损害与焦虑、抑郁的潜在关联，并观察上述指标是否与出院后30天内再入院事件存在相关性。**方法** 本研究为一项前瞻性观察性研究，纳入某私立医院收治的心力衰竭患者。分别采用医院焦虑抑郁量表（Hospital Anxiety and Depression Scale, HADS）与简易精神状态检查表（Mini Mental State Exam, MMSE）评估患者的心理状态与认知功能。入组时的临床资料从病历中提取，出院后30天通过电话随访完成随访工作。**结果** 本研究共纳入71例患者，其中男性占比83%，平均年龄为75±11岁。53.5%的患者存在认知功能损害，且以回忆记忆受损为最显著的认知改变。合并认知功能损害的患者中，可疑/确诊焦虑与抑郁的比例分别为21.1%与34.2%。仅抑郁症状与认知功能损害存在显著统计学关联（p=0.018）。认知功能损害、焦虑及抑郁均与出院后30天内再入院事件无显著相关性。**结论** 心力衰竭住院患者中，认知功能损害与抑郁症状较为普遍且二者存在关联，回忆记忆为受累最显著的认知域。但上述指标与出院后30天内再入院事件并无相关性。