Neurocognitive Changes Associated With Heart Failure: A Narrative Review

BACKGROUND: Up to 80% of people with heart failure experience cognitive impairment, which is linked to reduced cardiac function and cerebral hypoperfusion, causing neuropsychological changes related to brain injury. OBJECTIVES: To identify prevalent causes of heart failure-related cognitive impairment, synthesize literature on its indicators and mechanisms, discuss affected cognitive domains, and explore research and clinical implications. METHODS: This narrative review included empirical studies of cognitive performance in individuals with heart failure. Included studies were written in English and used original data. RESULTS: Cognitive impairment in individuals with heart failure is associated with disease severity, reduced ejection fraction, and lower systolic blood pressure. Cerebral hypoperfusion, microembolic events, and brain abnormalities contribute to deficits in attention, memory, and executive function. CONCLUSIONS: Further research is needed to understand the relationship between cerebral hemodynamics and cognitive function, identify early decline markers, and optimize screening and management strategies. Integrating cognitive screening into routine care may improve outcomes for individuals with heart failure-related cognitive impairment.