Practices and barriers in screening for cognitive impairment in heart failure: a clinician survey
ESC Heart Failure
Abstract
Cognitive impairment (CI) affects a significant percentage of heart failure (HF) patients, reducing adherence and worsening outcomes. Routine cognitive assessment remains limited.
To evaluate cognitive assessment practices, identify barriers, and examine associations between knowledge, attitudes, and clinical behaviours among clinicians managing HF patients.
An anonymous cross-sectional survey was distributed to 120 cardiologists across 68 clinics in the Hellenic Heart Failure Clinics Network (May–June 2025). The 13-question survey examined knowledge on cognitive decline, personal opinions on screening, assessment methods, and implementation obstacles. Associations were examined using Pearson’s chi-square.
Fifty-one cardiologists completed the survey, corresponding to a response rate of 42.5%. Among respondents 80% reported awareness of the high prevalence of cognitive decline, 14% systematically screened for CI presence. Main barriers reported were lack of time (76%) and inadequate familiarity with assessment tools (50%). Screening frequency was not associated with HF patient volume (χ2 = 4.75,
There is a gap between awareness of and testing for CI in HF patients, with the latter not being affected by clinicians’ patient load. Since there is universal interest in learning, integrating screening tools into daily routines and creating clear referral pathways may help in addressing this evidence-practice gap.
Contributors
Chris J Kapelios
Author
Stamatis Adamopoulos
Author
Apostolos Karavidas
Author
Sotirios Xydonas
Author
Antonis Sideris
Author
John Parissis
Author
Ioannis Alexanian
Author
Athanasios Anadiotis
Author
Xanthi Apostolidou
Author
Soultana Bakaimi
Author
Constantinos Bakogiannis
Author
Despoina Balta
Author
Dora Bambali
Author
Michael Bonios
Author
Alexandros Briasoulis
Author
Georgios Chalikias
Author
Eftychia Chamodraka
Author
Christos Chasikidis
Author
Christos Chatzieleftheriou
Author
Argirios Dalianis
Author
Georgios Diakakis
Author
Leonidas Diamantopoulos
Author
Stella Dourtsiou
Author
Metaxia Driva
Author
Dimitrios Farmakis
Author
Gerasimos Filippatos
Author
Katerina Fountoulaki
Author
Nikolaos Fragakis
Author
Gerasimos Gavrielatos
Author
Maria Georgopoulou
Author
Grigoris Giamouzis
Author
George Giannakoulas
Author
George Giannoglou
Author
Nikolaos Gouliaros
Author
Angeliki Gkouziouta
Author
Nikolaos Kalantzis
Author
Vasileios Kamperidis
Author
Nikolaos Kampouridis
Author
Iraklis Kapitsinis
Author
Theodoros Karamitsos
Author
Eleni Karapatsoudi
Author
Athanasios Kartalis
Author
Anastasia Katinioti
Author
Konstantinos Katsilis
Author
Anastasia Kitsiou
Author
Anna Kotsia
Author
Maria Kouli
Author
Nikos Kouris
Author
Stauroula Kosmopoulou
Author
Emmanouil Lamprogiannakis
Author
Stylianos Lampropoulos
Author
Evangelos Lazaris
Author
Ioannis Leontsinis
Author
Athanasios Manginas
Author
Polyxeni Mantzouratou
Author
Spyridon Maragkoudakis
Author
Maria Marketou
Author
Georgios Nikitas
Author
Petros Nikolopoulos
Author
Paraskevi Ntoliou
Author
Christodoulos Papadopoulos
Author
Dimitrios Papadopoulos
Author
Konstantinos Papadopoulos
Author
Georgios Papanikolaou
Author
Minas Pappas
Author
Stefanos Papastefanou
Author
Vasilios Sarakis
Author
Evangelos Sdogkos
Author
Maria Sifaki
Author
Vasiliki Sklirou
Author
Georgios Spyromitros
Author
Alexia Stavrati
Author
Ioannis Stratakis
Author
Maria Stratinaki
Author
Efstratios Theofilogiannakos
Author
Maria Thodi
Author
Konstantina Toli
Author
Konstantinos Tsatiris
Author
Georgios Tsinopoulos
Author
Konstantinos Tsiptsis
Author
Konstantinos Tsitlakidis
Author
Dimitrios Tziakas
Author
Elias Tsougos
Author
Vasileios Vasilakopoulos
Author
Vassilios Vassilikos
Author
Athanasios Vasilopoulos
Author
Niki Vlassopoulou
Author
Ioannis Vogiatzis
Author
Petros Voutas
Author
Alexandros Xanthopoulos
Author
Ermioni Zachariadi
Author
Antonios Ziakas
Author
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