{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T17:48:26Z","timestamp":1788371306176,"version":"build-2803163510"},"reference-count":47,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Cognitive impairment is a frequent and underrecognized comorbidity in elderly patients with heart failure with preserved ejection fraction (HFpEF), contributing to poor outcomes and complicating disease management. This study aimed to identify risk factors associated with cognitive impairment in elderly HFpEF patients from Western Romania and to develop a point-based risk score for clinical use. Methods: We conducted a cross-sectional analysis of HFpEF patients aged \u226565 years. Cognitive status was assessed using the Mini-Mental State Examination-2 (MMSE-2), with significant impairment defined as a score &lt;24. Multivariable logistic regression analysis was performed to identify independent predictors of cognitive dysfunction. Results: A total of 326 HFpEF patients were included. Diabetes mellitus, prior stroke or transient ischemic attack (TIA), carotid artery disease, elevated N-terminal pro\u2013B-type natriuretic peptide (NT-proBNP), and reduced estimated glomerular filtration rate (eGFR) were independently associated with cognitive impairment. Higher Kansas City Cardiomyopathy Questionnaire (12-KCCQ) scores and anticoagulant therapy for atrial fibrillation were associated with a lower risk. Based on these variables, a simple point-based cognitive risk score was developed, demonstrating strong discriminatory ability (area under the curve = 0.84). A threshold of \u22652 points identified cognitive impairment with 75% sensitivity and 83% specificity. Conclusions: Our findings underscore the importance of integrated cardiovascular and cognitive assessment in elderly HFpEF patients. The developed risk score offers a pragmatic tool for the early identification of cognitive dysfunction, potentially informing timely interventions and preventive strategies.<\/jats:p>","DOI":"10.3390\/jcm14113768","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T03:52:08Z","timestamp":1748404328000},"page":"3768","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Predicting Cognitive Impairment in Elderly Patients with HFpEF: Development of a Simple Clinical Risk Score"],"prefix":"10.3390","volume":"14","author":[{"given":"Sergiu-Florin","family":"Arnautu","sequence":"first","affiliation":[{"name":"Centre for Cognitive Research in Neuropsychiatric Pathology (NeuroPsy-Cog), Department of Neurosciences, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Sq., no.2, 300041 Timisoara, Romania"},{"name":"Multidisciplinary Heart Research Center, Department of Internal Medicine I, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2nd Eftimie Murgu Square, 340001 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda-Cristiana","family":"Bernad","sequence":"additional","affiliation":[{"name":"Multidisciplinary Heart Research Center, Department of Internal Medicine I, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2nd Eftimie Murgu Square, 340001 Timisoara, Romania"},{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Sq., no.2, 300041 Timisoara, Romania"},{"name":"Center for Neuropsychology and Behavioral Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Istvan Gyalai","family":"Korpos","sequence":"additional","affiliation":[{"name":"Multidisciplinary Heart Research Center, Department of Internal Medicine I, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2nd Eftimie Murgu Square, 340001 Timisoara, Romania"},{"name":"Cardiology Clinics, Timisoara Clinical Municipal Emergency Hospital, Bd. Revolutiei din 1989, no.12, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2117-0474","authenticated-orcid":false,"given":"Mirela-Cleopatra","family":"Tomescu","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Sq., no.2, 300041 Timisoara, Romania"},{"name":"Cardiology Clinics, Timisoara Clinical Municipal Emergency Hospital, Bd. Revolutiei din 1989, no.12, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minodora","family":"Andor","sequence":"additional","affiliation":[{"name":"Multidisciplinary Heart Research Center, Department of Internal Medicine I, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2nd Eftimie Murgu Square, 340001 Timisoara, Romania"},{"name":"Cardiology Clinics, Timisoara Clinical Municipal Emergency Hospital, Bd. Revolutiei din 1989, no.12, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7827-818X","authenticated-orcid":false,"given":"Catalin-Dragos","family":"Jianu","sequence":"additional","affiliation":[{"name":"Centre for Cognitive Research in Neuropsychiatric Pathology (NeuroPsy-Cog), Department of Neurosciences, \u201cVictor Babes\u201d University of Medicine and Pharmacy, E. Murgu Sq., no.2, 300041 Timisoara, Romania"},{"name":"Neurology Clinics II, County Clinical Emergency Hospital, 156 L. Rebreanu Ave., 300736 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9959-5718","authenticated-orcid":false,"given":"Diana-Aurora","family":"Arnautu","sequence":"additional","affiliation":[{"name":"Multidisciplinary Heart Research Center, Department of Internal Medicine I, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2nd Eftimie Murgu Square, 340001 Timisoara, Romania"},{"name":"Cardiology Clinics, Timisoara Clinical Municipal Emergency Hospital, Bd. Revolutiei din 1989, no.12, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.15420\/cfr.2023.05","article-title":"Global Public Health Burden of Heart Failure: An Updated Review","volume":"9","author":"Shahim","year":"2023","journal-title":"Card. Fail. 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