Emily C Gathright1, Michael J Fulcher, Mary A Dolansky, John Gunstad, Joseph D Redle, Richard Josephson, Shirley M Moore, Joel W Hughes. 1. Emily C. Gathright, MA PhD Candidate, Department of Psychological Sciences, Kent State University, Ohio. Michael J. Fulcher, BA Project Coordinator, Department of Psychiatry, Summa Health System, Akron City Hospital, Ohio. Mary A. Dolansky, PhD, RN Associate Professor, School of Nursing, Case Western Reserve University, Cleveland, Ohio. John Gunstad, PhD Professor, Department of Psychological Sciences, Kent State University, Ohio. Joseph D. Redle, MD Cardiologist, Cardiovascular Institute, Summa Health System, Akron City Hospital, Ohio. Richard Josephson, MD, MS Professor, School of Medicine, Case Western Reserve University; and Harrington Heart & Vascular Institute, University Hospitals, Cleveland, Ohio. Shirley M. Moore, PhD Professor, School of Nursing, Case Western Reserve University, Cleveland, Ohio. Joel W. Hughes, PhD Professor, Department of Psychological Sciences, Kent State University; and Department of Psychiatry, Summa Health System, Akron City Hospital, Akron, Ohio.
Abstract
BACKGROUND: Adults with heart failure (HF) often demonstrate impairment across multiple domains of cognitive functioning and report poor health-related quality of life (HRQoL). Previous researchers have found that cognitive deficits were generally not associated with HRQoL in a carefully evaluated sample. The exception was memory, which was only weakly associated with HRQoL. However, cognitive deficits interfere with self-care and disease self-management, which could be expected to affect HRQoL. OBJECTIVE: We sought to verify this counterintuitive finding in a large well-characterized sample of HF patients using a well-validated neuropsychological battery. METHODS: Participants were 302 adults (63% male) predominately white (72.5%) HF patients (68.7 ± 9.6 years) recruited from 2 medical centers. Self-reported HRQoL was assessed using the Kansas City Cardiomyopathy Questionnaire. Participants completed a neuropsychological battery examining attention, executive function, memory, and visuospatial functioning. Hierarchical multiple linear regression was used for analyses. RESULTS: Mild global cognitive impairment was observed in 29.5% of the sample (Modified Mini-Mental State [3MS] Examination score <90). Controlling for gender, depression, HF severity, premorbid IQ, comorbidities, and education, only executive function predicted HRQoL, β = .17, P < .05. However, executive function accounted for only 0.6% of the variance in HRQoL. CONCLUSION: Cognitive function generally did not predict HRQoL in HF patients. The correlates of HRQoL in HF do not appear to include mild cognitive impairment. Other factors may play a bigger role such as disease severity, age, and depressive symptoms. Future studies should investigate modifiable determinants of HRQoL in HF patients, toward the goal of finding interventions that preserve HRQoL during this chronic illness.
BACKGROUND: Adults with heart failure (HF) often demonstrate impairment across multiple domains of cognitive functioning and report poor health-related quality of life (HRQoL). Previous researchers have found that cognitive deficits were generally not associated with HRQoL in a carefully evaluated sample. The exception was memory, which was only weakly associated with HRQoL. However, cognitive deficits interfere with self-care and disease self-management, which could be expected to affect HRQoL. OBJECTIVE: We sought to verify this counterintuitive finding in a large well-characterized sample of HF patients using a well-validated neuropsychological battery. METHODS:Participants were 302 adults (63% male) predominately white (72.5%) HF patients (68.7 ± 9.6 years) recruited from 2 medical centers. Self-reported HRQoL was assessed using the Kansas City Cardiomyopathy Questionnaire. Participants completed a neuropsychological battery examining attention, executive function, memory, and visuospatial functioning. Hierarchical multiple linear regression was used for analyses. RESULTS: Mild global cognitive impairment was observed in 29.5% of the sample (Modified Mini-Mental State [3MS] Examination score <90). Controlling for gender, depression, HF severity, premorbid IQ, comorbidities, and education, only executive function predicted HRQoL, β = .17, P < .05. However, executive function accounted for only 0.6% of the variance in HRQoL. CONCLUSION: Cognitive function generally did not predict HRQoL in HF patients. The correlates of HRQoL in HF do not appear to include mild cognitive impairment. Other factors may play a bigger role such as disease severity, age, and depressive symptoms. Future studies should investigate modifiable determinants of HRQoL in HF patients, toward the goal of finding interventions that preserve HRQoL during this chronic illness.
Authors: Barbara Phillips-Bute; Joseph P Mathew; James A Blumenthal; Hilary P Grocott; Daniel T Laskowitz; Robert H Jones; Daniel B Mark; Mark F Newman Journal: Psychosom Med Date: 2006 May-Jun Impact factor: 4.312
Authors: I Appollonio; M Leone; V Isella; F Piamarta; T Consoli; M L Villa; E Forapani; A Russo; P Nichelli Journal: Neurol Sci Date: 2005-06 Impact factor: 3.307
Authors: Zvinka Z Zlatar; Raeanne C Moore; Barton W Palmer; Wesley K Thompson; Dilip V Jeste Journal: J Geriatr Psychiatry Neurol Date: 2014-03-10 Impact factor: 2.680
Authors: Kenneth E Freedland; Michael W Rich; Judith A Skala; Robert M Carney; Victor G Dávila-Román; Allan S Jaffe Journal: Psychosom Med Date: 2003 Jan-Feb Impact factor: 4.312
Authors: Debra K Moser; Cynthia Arslanian-Engoren; Martha J Biddle; Misook Lee Chung; Rebecca L Dekker; Muna H Hammash; Gia Mudd-Martin; Abdullah S Alhurani; Terry A Lennie Journal: Curr Cardiol Rep Date: 2016-12 Impact factor: 2.931
Authors: Misty A W Hawkins; Mary A Dolansky; Jennifer B Levin; Julie T Schaefer; John Gunstad; Joseph D Redle; Richard Josephson; Joel W Hughes Journal: Heart Lung Date: 2016 Sep-Oct Impact factor: 2.210