Cognitive Dysfunction as a Therapeutic Target in Heart Failure: A Systematic Review and Meta-Analysis of Randomized Trials

This registration describes the protocol for a systematic review and meta-analysis of randomized comparative trials evaluating cognitive interventions in adults with heart failure. The review aims to determine the effects of cognitive interventions on executive function as the primary outcome, and on other cognitive outcomes, patient-reported outcomes, functional outcomes, and clinical events as secondary outcomes. Eligible studies will include randomized comparative trials enrolling adults with heart failure and evaluating structured cognitive interventions with an explicit cognitive training, cognitive rehabilitation, or cognitive stimulation component against an eligible comparator group. Studies of psychological, behavioural, or psychotherapeutic interventions without an explicit cognitive component will be excluded. Searches will be conducted in PubMed, MEDLINE, Embase, PsycINFO, Scopus, Web of Science, and CENTRAL, supplemented by backward citation screening, forward citation tracking, and trial registry searches where feasible. Study screening will be managed in Covidence. Data extraction and statistical synthesis will be conducted in Review Manager Web (RevMan Web, Cochrane), and risk of bias will be assessed using RoB 2. The review is intended to clarify whether cognitive dysfunction is a modifiable therapeutic target in heart failure and to inform future intervention design and clinical research in this field.