Cognitive Impairment in Patients with Cardiac Disease: Implications for Clinical Practice

Astrid C. Van Nieuwkerk, Ronak Delewi, Frank J. Wolters, Majon Muller, Mat Daemen, Geert Jan Biessels*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

14 Citations (Scopus)


Cognitive impairment is common in patients with cardiovascular disease. One in 3 patients presenting at cardiology clinics have some degree of cognitive impairment, depending on the cardiac condition, comorbidities, and age. In up to half of these cases cognitive impairment may go unrecognized; however, it may affect self-management and treatment adherence. The high prevalence of cognitive impairment in patients with cardiac disease is likely due to shared risk factors, as well as direct consequences of cardiac dysfunction on the brain. Moreover, cardiac interventions may have beneficial as well as adverse effects on cognitive functioning. In this review, we describe prevalence and risk factors for cognitive impairment in patients with several common cardiac conditions: heart failure, coronary artery disease, and aortic valve stenosis. We discuss the potential effects of guideline-based treatments on cognition and identify open questions and unmet needs. Given the high prevalence of unrecognized cognitive impairment in cardiac patients, we recommend a stepwise approach to improve detection and management of cognitive impairment.

Original languageEnglish
Pages (from-to)2181-2191
Number of pages11
Issue number8
Publication statusPublished - Aug 2023

Bibliographical note

Funding Information:
Dr Wolters was consultant for the PGGM pension fund (fees paid to institution) and received research grants from the Brain & Behavior Research Foundation, The Netherlands Organisation for Health Research and Development (ZonMw) and The Alzheimer’s Association, outside of the submitted work. Dr Biessels also receives research funding from The Netherlands Organisation for Health Research and Development (ZonMw), Vici grant 918.16.616. Dr Delewi received educational fees from Boston Scientific and Edwards Lifesciences. The other authors report no conflicts.

Funding Information:
We acknowledge support from The Netherlands CardioVascular Research Initiative: The Dutch Heart Foundation (CVON 2018-28 and 2012-06 Heart Brain Connection), Dutch Federation of University Medical Centres, The Netherlands Organisation for Health Research and Development, and The Royal Netherlands Academy of Sciences.

Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.


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