eScholarship@UMMS

Title

Cognitive impairment and self-care in heart failure

Authors

Alexandra M. Hajduk, University of Massachusetts Medical School WorcesterFollow
Stephenie C. Lemon, University of Massachusetts Medical SchoolFollow
David D. McManus, University of Massachusetts Medical SchoolFollow
Darleen M. Lessard, University of Massachusetts Medical SchoolFollow
Jerry H. Gurwitz, University of Massachusetts Medical SchoolFollow
Frederick A. Spencer, McMaster University
Robert J. Goldberg, University of Massachusetts Medical SchoolFollow
Jane S. Saczynski, University of Massachusetts Medical SchoolFollow

Student Author(s)

Alexandra M. Hajduk

GSBS Program

Clinical & Population Health Research

UMMS Affiliation

Department of Quantitative Health Sciences; Meyers Primary Care Institute; Department of Medicine, Division of Preventive and Behavioral Medicine; Department of Medicine, Division of Geriatric Medicine

Date

10-24-2013

Document Type

Article

Disciplines

Behavior and Behavior Mechanisms | Cardiology | Cardiovascular Diseases | Epidemiology | Geriatrics | Psychiatric and Mental Health

Abstract

BACKGROUND: Heart failure (HF) is a prevalent chronic disease in older adults that requires extensive self-care to prevent decompensation and hospitalization. Cognitive impairment may impact the ability to perform HF self-care activities. We examined the association between cognitive impairment and adherence to self-care in patients hospitalized for acute HF.

DESIGN: Prospective cohort study.

SETTING AND PARTICIPANTS: A total of 577 patients (mean age = 71 years, 44% female) hospitalized for HF at five medical centers in the United States and Canada.

MEASUREMENTS AND METHODS: Participants were interviewed for information on self-reported adherence to self-care using the European Heart Failure Self-care Behaviour Scale. We assessed cognitive impairment in three domains (memory, processing speed, and executive function) using standardized measures. Patients' demographic and clinical characteristics were obtained through medical record review. Multivariable linear regression was used to examine the association between cognitive impairment and self-care practices adjusting for demographic and clinical factors.

RESULTS: A total of 453 patients (79%) were impaired in at least one cognitive domain. Average adherence to self-care activities among patients with global cognitive impairment did not differ significantly from those without cognitive impairment (30.5 versus 29.6; 45-point scale). However, impaired memory was associated with lower self-care scores (P = 0.006) in multivariable models.

CONCLUSION: Cognitive impairment is highly prevalent among older patients hospitalized for HF. Memory impairment is associated with poorer adherence to self-care practices. Screening for memory impairment in patients with HF may help to identify patients at risk for poor self-care who may benefit from tailored disease management programs.

Comments

Citation: Hajduk AM, Lemon SC, McManus DD, Lessard DM, Gurwitz JH, Spencer FA, Goldberg RJ, Saczynski JS. Cognitive impairment and self-care in heart failure. Clin Epidemiol. 2013 Oct 24;5:407-16. doi: 10.2147/CLEP.S44560. Link to article on publisher's website

Copyright 2013 Hajduk et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

Related Resources

Link to article in PubMed

Keywords

UMCCTS funding

Journal Title

Clinical Epidemiology

PubMed ID

24187511

Repository Citation

Hajduk, Alexandra M.; Lemon, Stephenie C.; McManus, David D.; Lessard, Darleen M.; Gurwitz, Jerry H.; Spencer, Frederick A.; Goldberg, Robert J.; and Saczynski, Jane S., "Cognitive impairment and self-care in heart failure" (2013). GSBS Student Publications. 1847.
https://escholarship.umassmed.edu/gsbs_sp/1847