Coronary Heart Disease, Cognitive Impairment and Patient‐Physician‐Communication: Data from the MenDis‐CHD study
Notice bibliographique
Résumé
Abstract Background Coronary heart disease (CHD) and dementia often co‐occur in the aging population. In addition, CHD seems to increase the risk for subsequent cognitive decline, which may in turn negatively affect the prognosis of CHD. Current CHD guidelines therefore recommend appropriate diagnosis and management of comorbid cognitive impairment. Here, we present the progression and characteristics of cognitive impairment in a group of patients with CHD and their perception of care in the patient‐physician‐relationship. Method For the MenDis‐CHD study, n = 364 patients with CHD were recruited from cardiologic hospital departments, rehabilitation clinics and cardiologist practices in Cologne, Germany. Medical records were used to assess severity of CHD and comorbidities. The New York Heart Association (NYHA) Functional Classification was applied for estimation of heart failure‐related symptom severity. Each patient was screened for cognitive impairment (DemTect) and depressive or anxiety symptoms (HADS questionnaire) as well as for subjective cognitive deficits. Patients were asked whether cognitive impairment was discussed with the treating physician. A follow‐up was carried out after M = 3.19 [2.2‐4.2] years in n = 118 patients. We compared patients whose cognition declined based on DemTect score to those who remained stable using t‐tests/Mann‐Whitney‐U‐tests and X²‐tests. Result At baseline, 10.2% of patients were screened positive for cognitive impairment, while 18.4% reported subjective cognitive deficits. Patients with a decline in cognition between study visits were significantly older (M = 67.9 vs. M = 63.1, t(115) = ‐2.7, p = .009) and showed more depressive symptoms (M = 5.0 vs. M = 3.8, t(115) = ‐2.1, p = .039). They also had more severe NYHA grades (M = 2.1 vs. M = 1.7, U(102) = 2044.5, p = .011) and a concomitant cerebrovascular diagnosis was more frequent compared to patients who did not decline (20.0% vs. 4.1%, X²(1) = 5.2, p = .048). Out of those who experienced either subjective or objective impairment at baseline (n = 88), 38.6% indicated that cognitive symptoms had previously been addressed during visits with their primary attending physician and 9.1% had been actively approached by their physician in this regard. Conclusion A relevant proportion of CHD patients displayed cognitive symptoms at baseline with progression at follow‐up. Conversations about cognitive symptoms with the physician occurred only in a minority. Our data supports the importance of raising awareness about the link between CHD and cognitive impairment in physicians.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,003 | 0,003 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».