Heart failure patients need to be given straight forward and clear instructions for the fear of loss of gray matter and declining mental faculties.

Team@CMHF

Heart failure is associated with a decline in mental function and loss of gray matter in the brain, which may make it more difficult for patients to follow instructions regarding their medication, a new Australian study has found.

Lead author Prof Osvaldo Almeida, commented to heartwire: “The regions of the brain that showed loss of gray matter are believed to be important for memory, reasoning, and planning. They are also consistent with the possibility that patients with heart failure may have trouble following complex management strategies.”

Instructions should be simple and clear
“So advice to patients should be simple and clear—complex instructions are unlikely to be understood and may decrease compliance. And health practitioners should repeat the management advice often and, if possible, seek the support of an available [caretaker] or next of kin,” Almeida continued.

He added that the best advice for patients to try to prevent cognitive decline associated with heart failure would be to tackle risk factors known to affect cognitive function, such as smoking, physical inactivity, lipid control, appropriate diet, management of hypertension, and diabetes.

Results showed that patients with heart failure had lower scores than patients with ischemic heart disease or healthy controls on cognitive tests measuring memory and psychomotor speed, although the difference between the heart-failure patients and those with ischemic heart disease was not significant.

This loss is the double of what you would expect with normal aging.

“We found that people with heart failure display more widespread and extensive brain changes than those with ischemic heart disease.”

MRI results showed that both ischemic heart disease patients and those with heart failure had loss of gray matter compared with controls in brain regions thought to be important for emotion and mental activity, and this loss was more pronounced in the heart-failure patients. “We found that people with heart failure display more widespread and extensive brain changes than those with ischemic heart disease,” Almeida said the mechanisms underlying these changes are unclear. “We could not attribute the changes to left ventricular output or to other biochemical markers commonly associated with heart failure. It seems clear that unmeasured factors play a role.”

Future research is aimed at determining whether the changes seen are progressive. The researchers are currently conducting a follow-up study to examine this question. “We also need to find out if these deficits can be reversed or ameliorated with appropriate rehabilitation—this is another area for which we hope to have some data soon,” Almeida said.

Ref: http://www.theheart.org/article/1351245.do