Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-10T17:28:03.010Z Has data issue: false hasContentIssue false
  • English
  • Français

Two-year course of cognitive function and mood in adults with congestive heart failure and coronary artery disease: the Heart-Mind Study

Published online by Cambridge University Press:  01 September 2011

Osvaldo P. Almeida ,
Christopher Beer ,
Nicola T. Lautenschlager ,
Leonard Arnolda ,
Helman Alfonso  and
Leon Flicker
Osvaldo P. Almeida*
Affiliation:
School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia Department of Psychiatry, Royal Perth Hospital, Perth, Australia
Christopher Beer
Affiliation:
Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia School of Medicine and Pharmacology, University of Western Australia, Perth, Australia Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia
Nicola T. Lautenschlager
Affiliation:
School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia Academic Unit for Psychiatry of Old Age, St Vincent's Health, Department of Psychiatry, University of Melbourne, Melbourne, Australia
Leonard Arnolda
Affiliation:
Academic Unit of Internal Medicine, Australian National University Medical School, Canberra, Australia
Helman Alfonso
Affiliation:
School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia
Leon Flicker
Affiliation:
Western Australian Centre for Health & Ageing, Centre for Medical Research, University of Western Australia, Perth, Australia School of Medicine and Pharmacology, University of Western Australia, Perth, Australia Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia
*
Correspondence should be addressed to: Professor Osvaldo P. Almeida, WA Centre for Health & Ageing (M573), University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia. Phone: +61 8 9224 2855. Email: osvaldo.almeida@uwa.edu.au.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Congestive heart failure (CHF) has been associated with impaired cognitive function, but it is unclear if these changes are specific to CHF and if they get worse with time. We designed this study to determine if adults with CHF show evidence of cognitive decline compared with adults with and without coronary artery disease (CAD).

Methods: A longitudinal study was carried out of 77 adults with CHF (ejection fraction, EF < 0.4), 73 adults with a clinical history of CAD and EF > 0.6, and 81 controls with no history of CAD. The Cambridge Cognitive Examination of the Elderly (CAMCOG) was the primary outcome measure. Secondary measures included the California Verbal Learning Test (CVLT), digit coding and copying, Hospital Anxiety and Depression Scale (HADS), and the short form health survey (SF36). Endpoints were collected at baseline and after 12 and 24 months.

Results: The adjusted CAMCOG scores of CHF participants declined 0.9 points over two years (p = 0.022) compared with controls without CAD. There were no differences between the groups on other cognitive measures. Participants with CHF and with CAD experienced similar changes in cognitive function over two years. Left ventricular EF and six-minute walk test results could not explain the observed associations.

Conclusions: The changes in cognitive function and mood associated with CHF over two years are subtle and not specific to CHF.

Keywords

congestive heart failurecoronary artery diseaseleft ventricular dysfunctiondepressionanxietymemoryattentioncognitioncognitive impairmentdementia
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 1 , January 2012 , pp. 38 - 47
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Almeida, O. P. and Flicker, L. (2001). The mind of a failing heart: a systematic review of the association between congestive heart failure and cognitive functioning. Internal Medicine Journal, 31, 290–295.CrossRefGoogle Scholar
Almeida, O. P. and Pfaff, J. J. (2005). Depression and smoking amongst older general practice patients. Journal of Affective Disorders, 86, 317–321.CrossRefGoogle ScholarPubMed
Almeida, O. P. and Tamai, S. (2001a). Clinical treatment reverses attentional deficits in congestive heart failure. BMC Geriatrics, 1, 2.CrossRefGoogle ScholarPubMed
Almeida, O. P. and Tamai, S. (2001b). Congestive heart failure and cognitive functioning amongst older adults. Arquivos de Neuropsiquiatria, 59, 324–329.CrossRefGoogle ScholarPubMed
Almeida, O. P., Hulse, G. K., Lawrence, D. and Flicker, L. (2002). Smoking as a risk factor for Alzheimer's disease: contrasting evidence from a systematic review of case-control and cohort studies. Addiction, 97, 15–28.CrossRefGoogle ScholarPubMed
Almeida, O. P. et al. (2007). Association of cardiovascular risk factors and disease with depression in later life. American Journal of Geriatric Psychiatry, 15, 506–513.CrossRefGoogle ScholarPubMed
Almeida, O. P. et al. (2008a). Coronary heart disease is associated with regional grey matter volume loss: implications for cognitive function and behaviour. Internal Medicine Journal, 38, 599–606.CrossRefGoogle ScholarPubMed
Almeida, O. P., Garrido, G. J., Lautenschlager, N. T., Hulse, G. K., Jamrozik, K. and Flicker, L. (2008b). Smoking is associated with reduced cortical regional gray matter density in brain regions associated with incipient Alzheimer disease. American Journal of Geriatric Psychiatry, 16, 92–98.CrossRefGoogle ScholarPubMed
Almeida, O. P., Calver, J., Jamrozik, K., Hankey, G. J. and Flicker, L. (2009). Obesity and metabolic syndrome increase the risk of incident depression in older men: the health in men study. American Journal of Geriatric Psychiatry, 17, 889–898.CrossRefGoogle ScholarPubMed
Almeida, O. P. et al. (2011). 24-month effect of smoking cessation on cognitive function and brain structure in later life. NeuroImage, 55, 1480–1489.CrossRefGoogle ScholarPubMed
Alves, T. C. et al. (2005). Localized cerebral blood flow reductions in patients with heart failure: a study using 99mTc-HMPAO SPECT. Journal of Neuroimaging, 15, 150–156.Google Scholar
Beardsall, L. and Huppert, F. A. (1994). Improvement in NART word reading in demented and normal older persons using the Cambridge Contextual Reading Test. Journal of Clinical and Experimental Neuropsychology, 16, 232–242.CrossRefGoogle ScholarPubMed
Beer, C. et al. (2009). Contributors to cognitive impairment in congestive heart failure: a pilot case-control study. Internal Medicine Journal, 39, 600–605.CrossRefGoogle ScholarPubMed
Bittner, V. (1997). Six-minute walk test in patients with cardiac dysfunction. Cardiologia, 42, 897–902.Google ScholarPubMed
Bruce, D. G. et al. (2003). Cognitive impairment, physical disability and depressive symptoms in older diabetic patients: the Fremantle Cognition in Diabetes Study. Diabetes Research and Clinical Practice, 61, 59–67.CrossRefGoogle Scholar
Castel, M. A. et al. (2010). Survival in New York Heart Association class IV heart failure patients treated with cardiac resynchronization therapy compared with patients on optimal pharmacological treatment. Europace, 12, 1136–1140.CrossRefGoogle ScholarPubMed
Crum, R. M., Anthony, J. C., Bassett, S. S. and Folstein, M. F. (1993). Population-based norms for the Mini-Mental State Examination by age and educational level. JAMA, 269, 2386–2391.CrossRefGoogle ScholarPubMed
Cukierman, T., Gerstein, H. C. and Williamson, J. D. (2005). Cognitive decline and dementia in diabetes: systematic overview of prospective observational studies. Diabetologia, 48, 2460–2469.CrossRefGoogle ScholarPubMed
Cullum, S. et al. (2000). Decline across different domains of cognitive function in normal ageing: results of a longitudinal population-based study using CAMCOG. International Journal of Geriatric Psychiatry, 15, 853–862.3.0.CO;2-T>CrossRefGoogle ScholarPubMed
Davies, M. et al. (2001). Prevalence of left-ventricular systolic dysfunction and heart failure in the Echocardiographic Heart of England Screening study: a population based study. Lancet, 358, 439–444.CrossRefGoogle ScholarPubMed
Delis, D. C., Freeland, J., Kramer, J. H. and Kaplan, E. (1988). Integrating clinical assessment with cognitive neuroscience: construct validation of the California Verbal Learning Test. Journal of Consulting Clinical Psychology, 56, 123–130.CrossRefGoogle ScholarPubMed
den Heijer, T. et al. (2005). Association between blood pressure, white matter lesions, and atrophy of the medial temporal lobe. Neurology, 64, 263–267.CrossRefGoogle ScholarPubMed
Forette, F. et al. (1998). Prevention of dementia in randomised double-blind placebo-controlled systolic hypertension in Europe (Syst-Eur) trial. Lancet, 352, 1347–1351.CrossRefGoogle ScholarPubMed
Gheorghiade, M. and Bonow, R. O. (1998). Chronic heart failure in the United States: a manifestation of coronary artery disease. Circulation, 97, 282–289.CrossRefGoogle ScholarPubMed
Gunstad, J. et al. (2006). Relation of brain natriuretic peptide levels to cognitive dysfunction in adults > 55 years of age with cardiovascular disease. American Journal of Cardiology, 98, 538–540.CrossRefGoogle ScholarPubMed
Gustafson, D. (2006). Adiposity indices and dementia. Lancet Neurology, 5, 713–720.CrossRefGoogle ScholarPubMed
Hobbs, F. D., Kenkre, J. E., Roalfe, A. K., Davis, R. C., Hare, R. and Davies, M. K. (2002). Impact of heart failure and left ventricular systolic dysfunction on quality of life: a cross-sectional study comparing common chronic cardiac and medical disorders and a representative adult population. European Heart Journal, 23, 1867–1876.CrossRefGoogle Scholar
Kalogeropoulos, A. et al. (2009). Epidemiology of incident heart failure in a contemporary elderly cohort: the health, aging, and body composition study. Archives of Internal Medicine, 169, 708–715.CrossRefGoogle Scholar
Koenig, H. G. (2006). Depression outcome in inpatients with congestive heart failure. Archives of Internal Medicine, 166, 991–996.CrossRefGoogle ScholarPubMed
Koschack, J. and Irle, E. (2005). Small hippocampal size in cognitively normal subjects with coronary artery disease. Neurobiology of Aging, 26, 865–871.CrossRefGoogle ScholarPubMed
Lautenschlager, N. T. et al. (2008). Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial. JAMA, 300, 1027–1037.CrossRefGoogle ScholarPubMed
Miller-Davis, C., Marden, S. and Leidy, N. K. (2006). The New York Heart Association Classes and functional status: what are we really measuring? Heart and Lung, 35, 217–224.CrossRefGoogle ScholarPubMed
Moorhouse, P. and Rockwood, K. (2008). Vascular cognitive impairment: current concepts and clinical developments. Lancet Neurology, 7, 246–255.CrossRefGoogle ScholarPubMed
Newman, M. F. et al. (2001). Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. New England Journal of Medicine, 344, 395–402.CrossRefGoogle ScholarPubMed
Ngandu, T. et al. (2007). Education and dementia: what lies behind the association? Neurology, 69, 1442–1450.CrossRefGoogle ScholarPubMed
Prins, N. D. et al. (2005). Cerebral small-vessel disease and decline in information processing speed, executive function and memory. Brain, 128, 2034–2041.CrossRefGoogle ScholarPubMed
Qiu, C., Winblad, B. and Fratiglioni, L. (2005). The age-dependent relation of blood pressure to cognitive function and dementia. Lancet Neurology, 4, 487–499.CrossRefGoogle ScholarPubMed
Riegel, B., Vaughan Dickson, V., Goldberg, L. R. and Deatrick, J. A. (2007). Factors associated with the development of expertise in heart failure self-care. Nursing Research, 56, 235–243.CrossRefGoogle ScholarPubMed
Riegel, B. et al. (2009). State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation, 120, 1141–1163.CrossRefGoogle ScholarPubMed
Sauve, M. J., Lewis, W. R., Blankenbiller, M., Rickabaugh, B. and Pressler, S. J. (2009). Cognitive impairments in chronic heart failure: a case controlled study. Journal of Cardiac Failure, 15, 1–10.CrossRefGoogle ScholarPubMed
Schall, R. R., Petrucci, R. J., Brozena, S. C., Cavarocchi, N. C. and Jessup, M. (1989). Cognitive function in patients with symptomatic dilated cardiomyopathy before and after cardiac transplantation. Journal of the American College of Cardiology, 14, 1666–1672.CrossRefGoogle ScholarPubMed
Selnes, O. A. et al. (2008). Cognition 6 years after surgical or medical therapy for coronary artery disease. Annals of Neurology, 63, 581–590.CrossRefGoogle ScholarPubMed
Stanek, K. M. et al. (2009). Longitudinal cognitive performance in older adults with cardiovascular disease: evidence for improvement in heart failure. Journal of Cardiovascular Nursing, 24, 192–197.CrossRefGoogle ScholarPubMed
Tanne, D. et al. (2005). Cognitive functions in severe congestive heart failure before and after an exercise training program. International Journal of Cardiology, 103, 145–149.CrossRefGoogle ScholarPubMed
Trojano, L., Antonelli Incalzi, R., Acanfora, D., Picone, C., Mecocci, P. and Rengo, F. (2003). Cognitive impairment: a key feature of congestive heart failure in the elderly. Journal of Neurology, 250, 1456–1463.CrossRefGoogle ScholarPubMed
van Dijk, E. J., Prins, N. D., Vrooman, H. A., Hofman, A., Koudstaal, P. J. and Breteler, M. M. (2008). Progression of cerebral small vessel disease in relation to risk factors and cognitive consequences: Rotterdam Scan study. Stroke, 39, 2712–2719.CrossRefGoogle ScholarPubMed
Vos, T. and Begg, S. (2007). The Burden of Cardiovascular Disease in Australia for the year 2003. Canberra: National Heart Foundation of Australia.Google Scholar
Ware, J. E. Jr. et al. (1998). The factor structure of the SF-36 Health Survey in 10 countries: results from the IQOLA Project. International Quality of Life Assessment. Journal of Clinical Epidemiology, 51, 1159–1165.CrossRefGoogle ScholarPubMed
Wechsler, D. (1997). Wechsler Adult Intelligence Scale III. Psychological Corporation.Google Scholar
Whitmer, R. A., Gustafson, D. R., Barrett-Connor, E., Haan, M. N., Gunderson, E. P. and Yaffe, K. (2008). Central obesity and increased risk of dementia more than three decades later. Neurology, 71, 1057–1064.CrossRefGoogle ScholarPubMed
Whooley, M. A. (2006). Depression and cardiovascular disease: healing the broken-hearted. JAMA, 295, 2874–2881.CrossRefGoogle ScholarPubMed
Williams, J. G., Huppert, F. A., Matthews, F. E. and Nickson, J. (2003). Performance and normative values of a concise neuropsychological test (CAMCOG) in an elderly population sample. International Journal of Geriatric Psychiatry, 18, 631–644.CrossRefGoogle Scholar
Woo, M. A., Macey, P. M., Fonarow, G. C., Hamilton, M. A. and Harper, R. M. (2003). Regional brain gray matter loss in heart failure. Journal of Applied Physiology, 95, 677–684.CrossRefGoogle ScholarPubMed
Woods, S. P., Delis, D. C., Scott, J. C., Kramer, J. H. and Holdnack, J. A. (2006). The California Verbal Learning Test, second edition: test-retest reliability, practice effects, and reliable change indices for the standard and alternate forms. Archives of Clinical Neuropsychology, 21, 413–420.CrossRefGoogle ScholarPubMed
Yohannes, A. M., Willgoss, T. G., Baldwin, R. C. and Connolly, M. J. (2010). Depression and anxiety in chronic heart failure and chronic obstructive pulmonary disease: prevalence, relevance, clinical implications and management principles. International Journal of Geriatric Psychiatry, 25, 1209–1221.CrossRefGoogle ScholarPubMed
Zigmond, A. S. and Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefGoogle ScholarPubMed
Zuccala, G., Cattel, C., Manes-Gravina, E., Di Niro, M. G., Cocchi, A. and Bernabei, R. (1997). Left ventricular dysfunction: a clue to cognitive impairment in older patients with heart failure. Journal of Neurology, Neurosurgery and Psychiatry, 63, 509–512.CrossRefGoogle ScholarPubMed