Prevalence and Latent Profiles of Cognitive Impairment in Patients with Heart Failure: A Secondary Data Analysis

Abstract

Background/Objectives: Cognitive impairment can weaken self-management competency in heart failure (HF) patients. This study estimated domain-specific cognitive impairment prevalence using actuarial criteria and identified latent cognitive profiles among Korean HF outpatients. Methods: Using a previously collected cross-sectional dataset of 106 HF outpatients, cognitive function was assessed with the Seoul Neuropsychological Screening Battery-II. Actuarial criteria determined domain-specific impairment, and latent profile analysis (LPA) derived cognitive profiles based on domain composite z-scores. Results: Any cognitive impairment (≥1 impaired domain) was present in 32.1% (95% confidence interval [CI], 24.0–41.5%), most frequently affecting executive function (17.9%) and memory (15.1%). LPA identified three exploratory profiles: relatively preserved (30.2%), memory-vulnerable (45.3%), and globally vulnerable (24.5%). In exploratory models, anxiety symptoms were associated with higher odds of memory-vulnerable profile membership (odds ratio [OR] = 2.81, 95% CI, 1.03–7.64) and overall vulnerability in a Firth penalized analysis (OR = 3.39, 95% CI, 1.46–8.11), whereas depressive symptoms showed no significant association. No associations remained statistically significant after false discovery rate correction. Conclusions: Cognitive vulnerability in HF outpatients is phenotypically heterogeneous and showed a possible, unconfirmed association with anxiety symptoms that did not remain statistically significant after correction for multiple comparisons. Outpatient HF care planning may benefit from considering both domain-specific deficits and latent cognitive profile patterns; however, these exploratory findings require validation in larger cohorts.