Prevalence of Cognitive Impairment in Heart Transplant Waiting-List Patients in a Developing Country

Purpose Cognitive impairment and mood deviation often occurs in patients with heart failure. Frailty and sarcopenia have been widely studied in patients with heart disease, but cognitive frailty has been little explored. High complexity of patients referred for heart transplantation connected with socioeconomic characteristics in a developing country underlines the importance to investigate cognitive and mood conditions in this population. The purpose of the study is to evaluate the prevalence of cognitive impairment and depression symptoms in patients with heart failure in waiting list for heart transplantation. Methods Cognition was assessed with the Montreal Cognitive Assessment (MoCA) and Wechsler Abbreviated Scale of Intelligence (WASI). Tables 1 and 2 show the domains evaluated by these tests and the established frailty criteria. Depression symptoms was assessed with Beck Depression Inventory (BDI). Patients included in waiting-list from Nov/2018 to May/2020 in our institution had its cognitive assessment in four weeks. Results 57 patients were evaluated; 77% were male; 49.9 was the average age; Chagas disease was the main etiology (38%), followed by dilated cardiomyopathy (28%) and ischemic cardiomyopathy (8%). 8.5 was the average of school years; 55% belong to social class “E” according to monthly family income and 28% reported history of mental health treatment or psychotropic use. Considering scales described above, 35% had mild symptons for depression; 89% denoted frailty on the brief cognitive screening test (MoCA) and 80% in the global intelligence scale (WASI), with emphasis on lower scores on non-verbal tasks over verbal tasks. Conclusion In our cohort, the prevalence of cognitive frailty in patients in heart transplant waiting list was alarming. Socioeconomic conditions seem to be a crucial issue in worse performance of candidates reflecting specific features and challenges regarding heart transplantation in a developing country.