Mechanism elucidation of cognitive cognitive impairment and its association with prognosis in heart failure

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K19298
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: General internal medicine(including psychosomatic medicine)
• Research Institution: St. Marianna University School of Medicine
• Principal Investigator: Kida Keisuke 聖マリアンナ医科大学, 医学部, 准教授 (60465432)
• Research Collaborator: Akashi Yoshihiro, J ; Suzuki Kengo ; Suzuki Norio ; Ito Chikayuki
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: 軽度認知障害 / 認知的フレイル / スクリーニング

Outline of Final Research Achievements

Of the 202 patients taking the screening test for dementia (mean age, 70 ± 11 years old), 130 patients were diagnosed as having dementia (the score < 8.5, 64%), whereas 72 patients are identified within the normal range (the score ≧ 9.0, 36%). The prognostic survey on the association between cognitive decline and HF rehospitalization had no association in 3 years, although, the readmitted patients in 1 year revealed the significantly lower Me-CDT scores (5.8 ± 2.5, 7.1 ± 2.4, p = 0.04).
Cognitive decline played a crucial factor in HF rehospitalization. Pentosidine, AGEs, was also associated with cognitive function and HF rehospitalization. Dementia, one of the Frail factors, should be screened; in particular, the screening test for MCI will be indispensable in a prospective intervention to verify whether HF rehospitalization is required or not.

Free Research Field

心不全

Academic Significance and Societal Importance of the Research Achievements

Me-CDTによる認知機能のスクリーニングを行なった心不全患者202例（平均年齢70±11歳）のうち、130名（64%）が8.5点以下で認知症の疑い、９点以上の正常は72名（36%）であり、高率に認知機能低下という結果であった。心不全の再入院における認知機能低下は重要なファクターであり、かつAGEsであるペントシジンは認知機能や心不全再入院と関連を認めた。フレイルの一要素である認知症、特に軽度認知障害(MCI; mild cognitive impairment)については、まずはスクリーニングが重要であり、今後は前向きの介入により心不全再入院が可能かの検証が必要である。