The association between mild cognitive impairment and self-care activity in community dwelling adult patients who have a diagnosis of chronic heart failure: a systematic review.

Review question/objective The objective of the review is to synthesise the best available evidence for an association between mild cognitive impairment and self-care activity in patients who have been diagnosed with chronic heart failure. The review question is: What is the evidence for an association between mild cognitive impairment and self-care activity, measured in one or more of the self-care domains related to heart failure in community dwelling adult patients who have a diagnosis of chronic heart failure? Inclusion criteria Types of participants Studies will include community dwelling adult patients (18 years and above) who have a diagnosis of chronic heart failure, at any stage of the New York Heart Association (NYHA) Classification of Heart Failure.35 Patients will be included regardless of gender, age, ethnic origin or any co-morbidity. Focus of the Review: The focus of the review is the epidemiological association between mild cognitive impairment (considered the presupposed risk factor) and self-care activity in the context of heart failure (considered the outcome). For the purposes of this review, mild cognitive impairment will be defined as evidence of impairment on a validated screening tool or diagnostic battery in individuals who do not have cognitive impairment that is severe enough to interfere with their basic activities of daily living. Studies that use validated instruments to measure cognitive function or impairment (as presupposed risk factor) will be considered for inclusion in this review. All included studies must also measure self-care capability or activities as outcomes of interest. This may be performed using validated tools, or more simple measures (such as percentage of missed medications). Self-care will include management of diet (including healthy diet, salt and fluid intake), medicines management, avoidance of risk factors for disease progression/deterioration, and symptom awareness and management.