Tunde Pal ^1,2* Laszlo Barna Iantovics ^3* Zoltan Preg ^4,5 Eniko Nemes-Nagy ^6,7 Kinga-Ilona Nyulas ⁸ Dragos-Florin Baba ^2,9 Marta German-Sallo ^10,5

• ¹ Department of Internal Medicine V, George Emil Palade University of Medicine Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
• ² 1st Department of Cardiology, Emergency Institute for Cardiovascular Diseases and Transplantation of Targu Mures, Targu Mures, Romania
• ³ Department of Electrical Engineering and Information Technology, Faculty of Engineering and Information Technology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Târg, Targu Mures, Romania
• ⁴ Department of Family Medicine, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Târgu Mureş, Targu Mures, Romania
• ⁵ Department of Cardiovascular Rehabilitation, County Emergency Clinical Hospital of Targu Mures, Targu Mures, Romania
• ⁶ Department of Chemistry and Medical Biochemistry, George Emil Palade University of Medicine Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
• ⁷ Department of Clinical Laboratory, Emergency County Hospital Targu Mures, Targu Mures, Romania
• ⁸ Doctoral School, George Emil Palade University of Medicine Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
• ⁹ Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Târgu Mureş, Targu Mures, Romania
• ¹⁰ Department of Internal Medicine III, George Emil Palade University of Medicine Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania

The impact of cardiovascular diseases on cognition raises important research questions. The study aimed to investigate the relationship between demographic data, cardiovascular diseases, kidney disease and depressive symptoms on cognition. A cross-sectional study of patients with cardiovascular diseases was performed. The Montreal Cognitive Assessment (MoCA) was applied for cognitive evaluation. Based on MoCA three groups were defined: preserved cognition, mild, and advanced cognitive dysfunction (CD). Data were analyzed using Cronbach alpha (Cα) and McDonald's ω (Mω) for internal consistency. The Chi-square test, Cramer's V test, and correlation analyses were also applied. Results: Of 628 patients, 55.2% had mild CD, and the mean age was 67.95 (SD 9.53) years. Cα and Mω were 0.7, indicating good internal consistency. We found a moderate positive correlation between depression and the severity of CD (r=0.25, p=0.0001). A weak association between CD and female gender (p=0.016), atrial fibrillation (p=0.03), stroke (p=0.009), and a moderate association for age group (p<0.0001), education level (p<0.0001), smoking (p<0.0001), and renal dysfunction (p<0.0001) was found. Age ≥70 years, eGFR 30-59 ml/min/1.73m 2 significantly increased the likelihood for mild and advanced CD, while smoking and >9 classes decreased it. Female gender, history of atrial fibrillation, and stroke significantly increased the likelihood of advanced CD. Mild CD was the most common in patients with cardiovascular diseases. Older age, lower education, being a non-smoker, and renal dysfunction were risk factors for both mild and advanced CD. Female gender, previous diagnosis of atrial fibrillation, and stroke are risk factors for advanced CD.