Michael L Alosco1, Mary Beth Spitznagel1, Ronald Cohen2, Naftali Raz3, Lawrence H Sweet4, Richard Josephson5, Joel Hughes6, Jim Rosneck7, John Gunstad8. 1. Department of Psychology, Kent State University, Kent, OH, USA. 2. Department of Neurology, University of Florida, USA; Department of Psychiatry, University of Florida, USA; The Institute on Aging, Center for Cognitive Aging and Memory, University of Florida, USA. 3. Institute of Gerontology, Wayne State University, Detroit, MI, USA. 4. Department of Psychology, University of Georgia, Athens, USA. 5. University Hospitals Case Medical Center and Department of Medicine, Cleveland, OH, USA; Harrington Heart & Vascular Institute, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA. 6. Department of Psychology, Kent State University, Kent, OH, USA; Cardiac Rehabilitation, Summa Health System, Akron City Hospital, Akron, OH, USA. 7. Cardiac Rehabilitation, Summa Health System, Akron City Hospital, Akron, OH, USA. 8. Department of Psychology, Kent State University, Kent, OH, USA. Electronic address: jgunstad@kent.edu.
Abstract
OBJECTIVE: Cognitive impairment in heart failure (HF) is believed to result from brain hypoperfusion subsequent to cardiac dysfunction. Physical inactivity is prevalent in HF and correlated with reduced cardiac and cognitive function. Yet, no longitudinal studies have examined the neurocognitive effects of physical inactivity in HF. The current study examined whether reduced physical activity increases risk for cognitive impairment and brain hypoperfusion over time in HF. METHODS: At baseline and 12 months later, 65 HF patients underwent neuropsychological testing, transcranial Doppler ultrasonography, and were asked to wear an accelerometer for seven days. RESULTS: Lower baseline step count and less time spent in moderate free-living activity best predicted worse attention/executive function and decreased cerebral perfusion at the 12-month follow-up. Decreased baseline cerebral perfusion also emerged as a strong predictor of poorer 12-month attention/executive function. CONCLUSIONS: Lower physical activity predicted worse cognition and cerebral perfusion 12 months later in HF. Physical inactivity in HF may contribute to cognitive impairment and exacerbate risk for conditions such as Alzheimer's disease. Larger studies are needed to elucidate the mechanisms by which physical inactivity leads to cognitive dysfunction in HF, including clarification of the role of cerebral hypoperfusion.
OBJECTIVE:Cognitive impairment in heart failure (HF) is believed to result from brain hypoperfusion subsequent to cardiac dysfunction. Physical inactivity is prevalent in HF and correlated with reduced cardiac and cognitive function. Yet, no longitudinal studies have examined the neurocognitive effects of physical inactivity in HF. The current study examined whether reduced physical activity increases risk for cognitive impairment and brain hypoperfusion over time in HF. METHODS: At baseline and 12 months later, 65 HF patients underwent neuropsychological testing, transcranial Doppler ultrasonography, and were asked to wear an accelerometer for seven days. RESULTS: Lower baseline step count and less time spent in moderate free-living activity best predicted worse attention/executive function and decreased cerebral perfusion at the 12-month follow-up. Decreased baseline cerebral perfusion also emerged as a strong predictor of poorer 12-month attention/executive function. CONCLUSIONS: Lower physical activity predicted worse cognition and cerebral perfusion 12 months later in HF. Physical inactivity in HF may contribute to cognitive impairment and exacerbate risk for conditions such as Alzheimer's disease. Larger studies are needed to elucidate the mechanisms by which physical inactivity leads to cognitive dysfunction in HF, including clarification of the role of cerebral hypoperfusion.
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