Introduction: Heart failure (HF) is a prevalent disease, affecting approximately 26 million people worldwide. It is a highly complex condition, with severe and limiting physical impairments. There is already data in the literature on cognitive impairments in this population, especially with regard to attention, executive and memory functions. The decline in such conditions is a warning point for the care team, since it can directly impact the self-care of these patients and even lead to a higher rate of readmissions and worsening of conditions due to difficulty in adhering to treatment. 

Objectives: To evaluate the cognitive decline of patients with HF in São Paulo. To correlate the cognitive screening score with ejection fraction (LVEF). To correlate the cognitive screening score with age.

Method: The Montreal Cognitive Assessment Test (MoCA) was applied to patients participating in a Clinical Care Program diagnosed with HF. Exclusion criteria were: previously diagnosed dementia syndrome, ICU admission or delirium. Then, the population was characterized, as well as the stratification of the total scores and of each cognitive function screened. The Spearman test was used to correlate these data with LVEF and age. 

Results: The sample consisted of 35 patients, with a mean age of 75±12 years, 85% men and 15% women. All had at least completed high school. The mean LVEF was 31±6% and the total MoCA score was 19±6. A significant decline was observed in all cognitive functions: executive (2±1); naming (2±0); attention (1±1); language (1±1); abstraction (1±1); memory (1±1) and orientation (5±1), with the deficit being more evident in executive, memory and attention. A slight correlation was evaluated between LVEF and the total MoCA score (-0.36 p=0.05) and also between age and the total MoCA score (-0.34 and p=0.06).

Conclusion: A significant decline in patients' cognitive functions was observed, especially in executive function, memory and attention, which are essential for adherence to drug and non-drug treatment. Thus, the need for therapeutic strategies such as guidance to family members, pamphlets, tables, among others, for assistance and integrated care for the patient is highlighted. The Clinical Care Program has a multidisciplinary team that, with these data, can reflect different ways of providing adequate care to this population.