The Relationship between Age and MMSE Performance Amongst Individuals with Heart Failure

Abstract Objective A previous meta-analysis assessing the impact of heart failure (HF) on cognition found the HF group performed more poorly than the healthy control (HC) on global cognition measures. The study observed a medium effect and moderate heterogeneity when using the Mini-Mental Status Examination (MMSE) to measure HF’s impact on global cognition. The current meta-regression explores whether the mean age of the HF group moderates performance on the MMSE when comparing HF patients to HC. Data Selection Two researchers independently searched eight databases, extracted data, and calculated effect sizes as part of a larger study. Inclusion criteria were: (a) adults with a diagnosis of HF, (b) comparison of HF patients to HC, and (c) adequate data to calculate effect sizes. Articles were excluded if patients had other types of organ failure, the article was not available in English, or there was a risk of sample overlap with another included study. Twelve articles (HF n = 1166 and HC n = 1948) were included. The unrestricted maximum likelihood computational model was used for the meta-regression. Data Synthesis Studies included in the meta-regression evidenced a statistically significant medium effect size estimate with moderate heterogeneity (k = 12, g = 0.671, p < 0.001, I2 = 80.91%). The meta-regression was statistically significant (slope = −0.023, p = 0.0022, Qmodel = 5.26, df = 1, p = 0.022). Conclusions Individuals with HF performed more poorly on the MMSE than HC. Larger effect sizes on the MMSE were observed in studies with participants who were younger compared to studies with participants who were older. Future research should continue to delineate the impact of age on global cognition in individuals with HF.