| Objective:Cognitive function was screened in elderly patients with heart failure using the Montreal Cognitive Assessment Scale(MoCA).To investigate the risk factors of mild cognitive impairment in elderly patients with heart failure.To analyze the effect of mild cognitive impairment on cardiovascular end-events in elderly patients with heart failure.Methods:From September 2020 to September 2021,elderly heart failure patients over 60 years old who were hospitalized in the Geriatric Department of the First Affiliated Hospital of Wannan Medical College and the First People’s Hospital of Wuhu were selected.1.MoCA scale was used to screen hospitalized elderly patients with heart failure for cognitive dysfunction.According to the screening results,100 elderly patients with heart failure were collected and divided into two groups:cognitive normal group and mild cognitive impairment group(MCI).2.Two groups of patients were recorded age,gender,educational level,merge disease,medication,type and grade of cardiac function,cardiac structure and function(including the EF values.LVEDD,6 minutes walk test,BNP)and were followed up for 3 months,two groups of patients with heart failure analysis record composite end point events(including heart failure readmission and cardiovascular death).3.In this study,SPSS25.0 software was used for preprocessing and statistical analysis of the data.Categorical variables are expressed by frequency and rate.Difference analysis adopts 2 test;continuous variable data distribution is described by mean ±standard deviation,and difference analysis adopts two independent sample t test.The analysis of influencing factors adopts the binary logistic regression model,and puts P<0.15 in the single factor analysis into the model fitting.The method adopts the backward stepwise regression method.The standard for variables entering the model is 0.1,and the standard for excluding the model is 0.15.P<0.05 is considered statistically significant.Results:1.The MoCA scale was used to evaluate the cognitive function of 100 elderly patients with heart failure conforming to the study criteria.There were 52 patients with cognitive impairment and 48 patients with cognitive normal,including 52%of elderly patients with heart failure complicated with MCI.The MoCA score of MCI group was lower than that of the control group,with statistical significance(P<0.05).2.Univariate analysis showed that age,sex,educational level,cardiac function grade,6-minute walking test,BNP,EF value,type of concomitant disease,number of heart failure readmission,number of falls and type of medication might be the influencing factors of mild cognitive impairment in elderly heart failure.P values were 0.000,0.048,0.000,0.000,0.000,0.047,0.037,0.019,0.000,0.001.0.004(all P<0.05).However,there was no significant difference in LVEDD(left ventricular end-diastolic diameter)and cardiovascular death between MCI patients and cognitive normal group,with P values of 0.100 and 0.170(both P>0.05).3.Age,sex,education level,cardiac function grade,6-minute walking test,BNP,EF value,type of disease,number of heart failure readmission,number of falls and type of medication were compared.The results showed that the statistically significant variables were education level,age and the 6-minute walk experiment.The partial regression coefficient of education level was-1.396,indicating that low education level was a risk factor for cognitive impairment.The risk of cognitive impairment was 0.248 times higher than that of the previous level for each level of education level,indicating that the possibility of cognitive impairment was reduced by 0.752 times.The partial regression coefficient of age was 0.145,high age was a risk factor for the occurrence of cognitive impairment,and the possibility of the occurrence of cognitive impairment increased 1.156 times with each increase of age unit.The higher the 6-minute walking score,the lower the likelihood of developing cognitive impairment,with a 0.006-fold reduction in the likelihood of developing cognitive impairment for each unit increase in score.Conclusion:Cardiac function grade,education level,age,sex,type of concomitant disease,6-minute walking test,BNP,EF value,number of heart failure readmission,number of falls and type of medication may be the risk factors for heart failure complicated with mild cognitive impairment in the elderly.Mild cognitive impairment increases readmission and cardiovascular adverse events in elderly patients with heart failure. |
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