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Editorial
. 2024 Jun 21;16(6):e62838.
doi: 10.7759/cureus.62838. eCollection 2024 Jun.

Addressing the Need for Universal Cognitive Assessment Among Older Adults With Congestive Heart Failure

Myrna K Serna  1 , Shilpa Rajagopal  2 , Sunil K Sahai  1 , Mukaila Raji  3
Affiliations
Editorial

Addressing the Need for Universal Cognitive Assessment Among Older Adults With Congestive Heart Failure

Myrna K Serna et al. Cureus. .

Abstract

Congestive heart failure (CHF) and cognitive impairment (CI) are common in older age and often occur together. However, CI is often unrecognized leading to more hospitalizations and increased morbidity and mortality in patients with co-occurring CHF and CI. Universal screening can help identify these patients earlier and the use of the Institute of Healthcare Improvement's (IHI) 4Ms Framework (i.e. "What Matters, Medication, Mentation, and Mobility") can serve as a tool for providers to meet patients' needs surrounding goals of care, medication regimens, mental and emotional well-being, and mobility capabilities through a social determinants of health lens. Providers should engage in serious illness conversations early to honor patient preferences, reduce polypharmacy, use a validated instrument to assess cognition such as the Mini-Cog or Functional Activities Questionnaire, and assess the need for assistance completing activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Consultation with social work is highly recommended given the complexity of the medical and social needs of newly discharged cognitively impaired CHF patients and the need to optimize the use of all available community resources.

Keywords: cognitive impairment; dementia; geriatrics; heart failure; mortality.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Priority considerations using the IHI 4Ms Framework for patients with co-occurring CHF and CI
CHF: congestive heart failure; CI: cognitive impairment The image was created by the authors of this article. The icons at the top of the figure are from the free Canva graphics. The figure was included as part of a poster presented previously by the authors of this article at the 2023 UTMB Annual Forum on Aging (Rajagopal S, Serna MK, Pujari SH, Khan F, Kaushik V, Raji M. Addressing the Need for Universal Cognitive Testing Among Older Adults with Congestive Heart Failure. Poster presented at: 26th Annual Forum on Aging; 2023 October; Galveston, TX.)
See this image and copyright information in PMC

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