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Published on: February 28, 2012
Change in cognitive function over 12 months among patients with an implantable cardioverter-defibrillator
Jinshil Kim1, Susan J Pressler, William J Groh
1JinShil Kim, PhD, RN Assistant Professor, Department of Nursing, Sunchon National University, South Korea. Susan J. Pressler, PhD, RN Professor and Associate Dean for Graduate Studies, School of Nursing, University of Michigan, Ann Arbor. William J. Groh, MD, MPH Associate Professor of Medicine and Cardiology Fellowship Program Director, Krannert Institute of Cardiology, School of Medicine, Department of Medicine, Indiana University, Indianapolis.
Insights
Cognitive function in implantable cardioverter-defibrillator (ICD) patients declined over 12 months, particularly memory recall. This study highlights memory decline in ICD recipients, suggesting further research into its impact on patient outcomes.
Area of Science:
- Cardiology
- Neuropsychology
- Medical Devices
Background:
- Patients with implantable cardioverter-defibrillators (ICDs) often experience cognitive decline linked to cardiac conditions.
- Limited understanding exists regarding longitudinal changes in cognitive function among ICD patients.
Purpose of the Study:
- To assess 12-month changes in cognitive function, including memory, psychomotor speed, and executive function, in patients with ICDs.
- To evaluate the trajectory of cognitive performance from baseline to one year post-implantation.
Main Methods:
- A prospective study involving 115 patients at baseline and 77 at 12 months.
- Neuropsychological tests administered during face-to-face interviews to measure cognitive domains.
- Analysis of changes in total recall, delayed recall, psychomotor speed, and executive function.
Main Results:
- Significant decreases in total and delayed recall memory were observed from baseline to 12 months (P < .05).
- No significant changes were noted in psychomotor speed or executive function over the study period.
- 12% to 22% of ICD patients exhibited poor cognitive function, specifically memory, over time.
Conclusions:
- Memory function in patients with ICDs was impaired at baseline and further declined over 12 months.
- These findings underscore the need for further investigation into the impact of memory decline on outcomes like medication adherence in ICD patients.
Background:
Patients with implantable cardioverter-defibrillators (ICDs) have decreased cognitive function associated with arrhythmic and/or cardiac disorders, such as ischemic cardiomyopathy. Little is known about changes in cognitive function over time among ICD patients.
Aims:
The aim of this study was to evaluate baseline-to-12-month changes in cognitive function in memory (total recall and delayed recall), psychomotor speed, and executive function among ICD patients.
Methods:
In this prospective study, 115 (mean [SD] age, 64.83 [9.06] years, 75% mean) and 77 ICD patients completed baseline and 12-month face-to-face interviews, respectively, which included neuropsychological tests to evaluate cognitive function.
Results:
Patients who completed baseline and 12-month testing had decreased total and delayed recall memory (all P < .05). No significant changes from baseline to 12 months were observed in psychomotor speed (t = 0.33; P = .74) and executive function (t = -1.12; P = .27). Using 1.0 standard deviation or below the mean as a cutoff criterion, 12% to 22% of ICD patients had poor cognitive function over time. Particularly, at baseline, 17 (15%) and 15 (13%) of the 115 patients had poor memory in total and delayed recall, respectively. At 12 months, 12 (16%) and 9 (12%) of the 77 patients had poor memory in total and delayed recall, respectively.
Conclusions:
In this sample of patients with ICDs, memory was poor at baseline and decreased over 12 months. Future studies are indicated to determine how this change in memory influences outcomes such as medication adherence.
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