Cognitive function among long‐term survivors of heart transplantation

• Published in: Clinical transplantation Vol. 31; no. 12
• Main Authors: Bürker, Britta S., Gude, Einar, Gullestad, Lars, Grov, Ingelin, Relbo Authen, Anne, Andreassen, Arne K., Havik, Odd E., Dew, Mary Amanda, Fiane, Arnt E., Haraldsen, Ira R., Malt, Ulrik F., Andersson, Stein
• Format: Journal Article
• Language: English
• Published: Denmark 01-12-2017
• Subjects: Adult; cognition; Cognition Disorders - etiology; cognitive dysfunction; Female; Follow-Up Studies; heart transplantation; Heart Transplantation - adverse effects; Humans; Male; Middle Aged; Neuropsychological Tests; Prognosis; Survival Rate; Survivors - statistics & numerical data; cognition; heart transplantation; cognitive dysfunction
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/ctr.13143

Background
Cognitive impairment is documented early after heart transplantation (HTx), but we lack data on cognitive function beyond the fourth year post‐transplant. Against the background of good long‐term survival, this knowledge is necessary to improve clinical care throughout the entire post‐transplant period.
Methods
We assessed cognitive function with a neuropsychological test battery in a sample of HTx recipients ≥16 years post‐transplant. To improve clinical utility, we also applied adapted consensus criteria for Mild Cognitive Impairment (MCI). Furthermore, we explored sociodemographic and clinical characteristics possibly related to cognitive function.
Results
Thirty‐seven subjects were included 20.3 (±3.8) years after HTx. Mean age was 57.5 (±14.2) years, and 18.9% were women. Up to 38.9% exhibited impaired test performance (ie, performance at least 1.5 standard deviations below the normative mean) on several individual cognitive measures, especially on measures of processing speed, executive functions, memory, and language functions. One subject was diagnosed with dementia, and 30.1% qualified for MCI. Those with MCI had lower hemoglobin than those without.
Conclusions
A substantial proportion of long‐term survivors of HTx might be cognitively impaired. The level of impairment appears comparable to what is defined as MCI in the literature. Modifiable factors related to cognitive impairment might exist.