TY - JOUR
T1 - Longitudinal cognitive performance in older adults with cardiovascular disease
T2 - Evidence for improvement in Heart Failure
AU - Stanek, Kelly M.
AU - Gunstad, John
AU - Paul, Robert H.
AU - Poppas, Athena
AU - Jefferson, Angela L.
AU - Sweet, Lawrence H.
AU - Hoth, Karin F.
AU - Haley, Andreana P.
AU - Forman, Daniel E.
AU - Cohen, Ronald A.
PY - 2009/5
Y1 - 2009/5
N2 - BACKGROUND:: Cardiovascular disease (CVD) and particularly heart failure (HF) have been associated with cognitive impairment in cross-sectional studies, but it is unclear how cognitive impairment progresses over time in older adults with these conditions. OBJECTIVE:: The aim of this study was to prospectively examine cognitive function in patients with HF versus other forms of CVD. METHOD:: Seventy-five older adults (aged 53-84 years) with CVD underwent Doppler echocardiogram to evaluate cardiac status and 2 administrations of the Dementia Rating Scale (DRS), a test of global cognitive functioning, 12 months apart. RESULTS:: Although DRS performance did not statistically differ between groups at either administration, a significant between-group difference in the rate of cognitive change emerged (λ = 0.87; F = 10.50; P = .002; ω = 0.11). Follow-up analyses revealed that patients with HF improved significantly on global DRS performance, whereas patients with other forms of CVD remained stable. More specifically, patients with HF showed improvement on subscales of attention, initiation/perseveration, and conceptualization. Exploratory analyses indicated that higher diastolic blood pressure at baseline was associated with improved DRS performance in patients with HF (r = 0.38; P = .02). CONCLUSIONS:: Patients with HF exhibited modest cognitive improvements during 12 months, particularly in attention and executive functioning. Higher diastolic blood pressure at baseline was associated with improvement. These results suggest that cognitive impairment in patients with HF may be modifiable and that improved blood pressure control may be an important contributor to improved function. Further prospective studies are needed to replicate results and determine underlying mechanisms.
AB - BACKGROUND:: Cardiovascular disease (CVD) and particularly heart failure (HF) have been associated with cognitive impairment in cross-sectional studies, but it is unclear how cognitive impairment progresses over time in older adults with these conditions. OBJECTIVE:: The aim of this study was to prospectively examine cognitive function in patients with HF versus other forms of CVD. METHOD:: Seventy-five older adults (aged 53-84 years) with CVD underwent Doppler echocardiogram to evaluate cardiac status and 2 administrations of the Dementia Rating Scale (DRS), a test of global cognitive functioning, 12 months apart. RESULTS:: Although DRS performance did not statistically differ between groups at either administration, a significant between-group difference in the rate of cognitive change emerged (λ = 0.87; F = 10.50; P = .002; ω = 0.11). Follow-up analyses revealed that patients with HF improved significantly on global DRS performance, whereas patients with other forms of CVD remained stable. More specifically, patients with HF showed improvement on subscales of attention, initiation/perseveration, and conceptualization. Exploratory analyses indicated that higher diastolic blood pressure at baseline was associated with improved DRS performance in patients with HF (r = 0.38; P = .02). CONCLUSIONS:: Patients with HF exhibited modest cognitive improvements during 12 months, particularly in attention and executive functioning. Higher diastolic blood pressure at baseline was associated with improvement. These results suggest that cognitive impairment in patients with HF may be modifiable and that improved blood pressure control may be an important contributor to improved function. Further prospective studies are needed to replicate results and determine underlying mechanisms.
KW - Cardiovascular disease
KW - Cognitive impairment
KW - Heart failure
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U2 - 10.1097/JCN.0b013e31819b54de
DO - 10.1097/JCN.0b013e31819b54de
M3 - Article
C2 - 19390336
AN - SCOPUS:67650324263
SN - 0889-4655
VL - 24
SP - 192
EP - 197
JO - Journal of Cardiovascular Nursing
JF - Journal of Cardiovascular Nursing
IS - 3
ER -