Introduction (relevance). The relationship between chronic heart failure (CHF) and cognitive impairment has been established (CI), but the pathogenetic mechanisms of the relationship between the two functional disorders have not been fully studied. Especially important is the study of the interdependence of CHF and CI in the elderly due to the negative impact of aging on intellectual-mnestic and motor functioning. Target. To optimize the differential diagnostic approach of CI in patients with CHF of older age groups. Materials and methods. Materials of literature data for the last 10 years have been studied. Research methods: The writing of the article was based on general scientific research methods, including methods of interpretation, comparison, generalization within the framework of bibliographic analysis. Results. It has been established that a decrease in the left ventricular ejection fraction increases the likelihood of developing CI. In the elderly and senile age, the patient's compliance is significantly reduced, which further exacerbates the situation for the therapeutic correction of CHF. Discussions. Along with basic treatment, additional support for cognitive functionality is needed. CI should be considered as a way of early prediction of intellectual-mnestic disorders due to their asymptomatic course in the initial stages, and the lack of adequate therapy leads to progression and the formation of a vicious circle, leading to aggravation of CHF. Conclusions (conclusion). Early verification of CI in patients with CHF of older age groups allows not only to make a correct diagnosis, but also to positively influence the quality of life and prognosis of CHF in elderly and senile people.