International Psychogeriatrics

Research Article

Two-year course of cognitive function and mood in adults with congestive heart failure and coronary artery disease: the Heart-Mind Study

Osvaldo P. Almeidaa1a2a3 c1, Christopher Beera2a4a5, Nicola T. Lautenschlagera1a2a6, Leonard Arnoldaa7, Helman Alfonsoa1a2 and Leon Flickera2a4a5

a1 School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia

a2 Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia

a3 Department of Psychiatry, Royal Perth Hospital, Perth, Australia

a4 School of Medicine and Pharmacology, University of Western Australia, Perth, Australia

a5 Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia

a6 Academic Unit for Psychiatry of Old Age, St Vincent's Health, Department of Psychiatry, University of Melbourne, Melbourne, Australia

a7 Academic Unit of Internal Medicine, Australian National University Medical School, Canberra, Australia


Background: Congestive heart failure (CHF) has been associated with impaired cognitive function, but it is unclear if these changes are specific to CHF and if they get worse with time. We designed this study to determine if adults with CHF show evidence of cognitive decline compared with adults with and without coronary artery disease (CAD).

Methods: A longitudinal study was carried out of 77 adults with CHF (ejection fraction, EF < 0.4), 73 adults with a clinical history of CAD and EF > 0.6, and 81 controls with no history of CAD. The Cambridge Cognitive Examination of the Elderly (CAMCOG) was the primary outcome measure. Secondary measures included the California Verbal Learning Test (CVLT), digit coding and copying, Hospital Anxiety and Depression Scale (HADS), and the short form health survey (SF36). Endpoints were collected at baseline and after 12 and 24 months.

Results: The adjusted CAMCOG scores of CHF participants declined 0.9 points over two years (p = 0.022) compared with controls without CAD. There were no differences between the groups on other cognitive measures. Participants with CHF and with CAD experienced similar changes in cognitive function over two years. Left ventricular EF and six-minute walk test results could not explain the observed associations.

Conclusions: The changes in cognitive function and mood associated with CHF over two years are subtle and not specific to CHF.

(Received May 12 2011)

(Revised June 09 2011)

(Revised June 28 2011)

(Accepted June 30 2011)

(Online publication September 01 2011)


c1 Correspondence should be addressed to: Professor Osvaldo P. Almeida, WA Centre for Health & Ageing (M573), University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia. Phone: +61 8 9224 2855. Email:

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