Mild cognitive impairment causes cognitive changes that are serious enough to be noticed by the individuals. Approximately 15 to 20 percent of people age 65 or older have MCI. This impairment may increase the risk of cardiovascular events.

Few studies have shown the impact of altered mental status on mortality and CV events. Even less in elderly with valvular heart disease.

We made a monocentric prospective study for 12 months, data collected at the echolab and consultations among patients with valvular disease. To assess mild cognitive impairment (MCI) we have used the Mini Mental Status Evaluation which is a 30-point questionnaire that is used extensively in clinical and research settings. After exclusion for neurological problems, psychiatric disorders, we defined MCI by MMSE<24. We compared 2 groups of patients G1<70 years and G2>70 years who were eligible to study.

Eighty six patients were included, 48 in G1 and 38 in G2, mean age was G1 58±7 vs. G2 78±5 years. MCI was correlated with female gender (54% vs. 35% P=0.03), low education state (10% vs. 35% P=0.001). AF was present in 5% in G1 vs. 12% in G2, and heart failure (HF 22% vs. 37% P=0.035). Mitral stenosis was identified (20% vs. 17%), MR (10% vs. 12%), LVEF>50% in (80% vs. 65%), PAH in 38% each group, whereas aortic stenosis was significantly associated with MCI in second group of elderly patients (5% vs. 12% P=0.04). The medical therapy was similar between 2 groups. Mortality and rehospitalization in 3months were higher in G2 of (3.6% vs. 12%, P=0.01 and 20% vs. 36%, P=0.002).

Routine assessment of MCI should be done in elderly with valvular heart disease specially population with AS. A specific management of such high-risk patients should be considered.