Older patients with heart failure had more memory problems when their heart ailments were advanced, according to a new study of adults being evaluated for transplants.
But that wasn't the case in young and middle-aged adults with heart failure, marked by a low left ventricular ejection fraction (LVEF).
"As you get older, there's more atrophy" in the brain, said study author Dr Joanne Festa, from St. Luke's-Roosevelt Hospital in New York. "It could be that particularly in heart failure the brain atrophies at a quicker rate."
The findings tell cardiologists they need to be aware that their patients might be at higher risk of memory problems – problems that could come into play in their heart treatment, Dr Festa added.
Decline of memory happens very slowly
"Memory plays a role in how you manage your health," she said. "Do you remember to take your medication, keep up with follow-up appointments and, do you remember the symptoms that you have."
In addition, when memory decline is linked to heart failure, it might come on very slowly, and not be noticed until it's advanced.
Dr Festa and her colleagues collected data from memory tests in 207 heart failure patients who were being evaluated to see if they were candidates for a heart transplant. The researchers split those patients up into 169 who had low scores on a test of heart function and 38 who had better scores.
In general, patients younger than 63 performed similarly on memory tests, regardless of left ventricular function, according to a report online in the Archives of Neurology.
Depression also linked to loss of memory
But in older patients, a low LVEF was linked to a 1% lower score on combined memory tests, especially on tests that measured how well they recognised and remembered words.
"They learn at about the same rate, but essentially they don't hold on to the information," Dr Festa said. "They don't remember it, and they don't recognize it – which is very relevant to remembering what your doctor said to you in the office."
In younger patients, she added, the brain may be able to compensate for lower blood flow – while an already-ageing brain might suffer more from the impact of heart failure.
The researchers found that poor memory was also linked to depression symptoms and attention problems.
Doctors should take note of these findings
Dr Festa said there's strong evidence implicating heart disease in thinking and memory difficulties, but that studies looking specifically at left ventricle problems have been less consistent. Now, it seems that part of that inconsistency could be due to varied ages of patients in different studies.
The findings are something for older heart patients, and the doctors treating them, to take note of, the researcher said.
"Everyone is concerned about their memory; memory is an important part of everyday functioning," Dr Festa said. "But it also plays an important role in health outcomes."
Doctors need to be aware that many of these patients should be evaluated, even if the patients don't report memory problems.
(Reuters Health, August 2011)
Left ventricular ejection fraction