GANGGUAN KOGNITIF PADA PASIEN GAGAL JANTUNG KONGESTIF DAN FAKTORFAKTOR YANG MEMPENGARUHINYA

Introduction: Cognitive impairment are found more common in congestive heart failure patients compare to normal population. Decline in cognitive function can significantly reduce patients’ quality of life and increase both morbidty and mortality. Objective: To assess the prevalence of cognitive impairment in patients with congestive heart failure and determinant factors that may contribute to it. Methods: Cross sectional study was done among congestive heart failurepatientswith range of age 40-75 years old who came to RSCM on August-October 2009. Cognitive function was assessed by MMSE and STLNB. Independent variables assesed in this study were age, level of education, duration of illness, severity of illness (based on NYHA and ejection fraction of left ventricle) and others vascular risk (hypertension, dyslipidemia, DM).
Results: Among 73 subject, 11% had cognitive dysfunction by MMSE and 50,7% by STLNB. Subject with cognitive dysfunction had older mean of age compared with subject without cognitive dysfunction and the differences were significant (62.73±7.59 vs 57.97±10.53, p=0.078). There was a significant association between level of education with cognitive dysfunction (p=0.001) and so as with Severity of illness. Subject with higher functional class of NYHA (II and III) had more risk to get cognitive impairment than lower class (I). Subject with ejection fraction less than 45% more likely had cognitive impairment (OR 95%CI 4.87 (1.42-16.72), p=0.008). Based on logistic regretion analysis, NYHA functional class III was the most contributing factor to cognitive dysfunction (OR 95%CI: 29.83(2.95-01.3), p=0.004). Conclusions: Prevalences of cognitive dysfunction among patients with congestive heart failure was 50.7%. This prevalences significantly associated with level of education, mean of age and severity of illness.