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Greater body mass index is associated with poorer cognitive functioning in male heart failure patients
Misty A W Hawkins1, John Gunstad1, Mary A Dolansky2
1Department of Psychology, Kent State University, Kent, Ohio.
Insights
Higher body mass index (BMI) is linked to poorer attention and executive function in men with heart failure (HF), particularly those with severe obesity. This association was not found in women with HF.
Area of Science:
- Cardiology
- Neurology
- Obesity Research
Background:
- Heart failure (HF) and obesity are independently linked to cognitive impairment.
- Sex-specific differences in HF prognosis exist, yet the relationship between adiposity and cognition in HF patients remains understudied by sex.
- Existing research lacks detailed investigation into how body mass index (BMI) affects cognitive functions within the heart failure population, stratified by sex.
Purpose of the Study:
- To test the hypothesis that greater BMI is associated with poorer cognitive functioning in heart failure patients.
- To investigate potential sex differences in the association between BMI and cognitive function in HF.
- To examine the impact of severe obesity (BMI ≥40 kg/m²) on cognitive performance in male HF patients.
Main Methods:
- A cohort of 231 heart failure patients (34% female) was analyzed.
- Body mass index (BMI) was calculated from height and weight measurements.
- A neuropsychological test battery assessed global cognition, memory, attention, and executive function, with results analyzed using regression models adjusted for relevant factors.
Main Results:
- The study sample was predominantly overweight or obese (76.2%).
- In men, higher BMI significantly predicted poorer attention and executive function, with severe obesity driving these effects.
- No significant association was observed between BMI and cognitive variables in women with heart failure.
Conclusions:
- Increased BMI is associated with diminished attention and executive function in male heart failure patients, especially those with severe obesity.
- These cognitive deficits in male HF patients with higher BMI may impede adherence to treatment regimens and negatively impact overall outcomes.
- The findings highlight the importance of considering sex-specific effects of obesity on cognitive function in heart failure management.
Background:
Heart failure (HF) and obesity are associated with cognitive impairment. However, few studies have investigated the relationship between adiposity and cognitive functioning in HF for each sex, despite observed sex differences in HF prognosis. We tested the hypothesis that greater body mass index (BMI) would be associated with poorer cognitive functioning, especially in men, in sex-stratified analyses.
Methods And Results:
Participants were 231 HF patients (34% female, 24% nonwhite, average age 68.7 ± 7.3 years). Height and weight were used to compute BMI. A neuropsychology battery tested global cognitive function, memory, attention, and executive function. Composites were created using averages of age-adjusted scaled scores. Regressions adjusting for demographic and medical factors were conducted. The sample was predominantly overweight/obese (76.2%). For men, greater BMI predicted poorer attention (ΔR(2) = 0.03; β = -0.18; P = .01) and executive function (ΔR(2) = 0.02; β = -0.13; P = .04); these effects were largely driven by men with severe obesity (BMI ≥40 kg/m(2)). BMI did not predict memory (P = .69) or global cognitive functioning (P = .08). In women, greater BMI was not associated with any cognitive variable (all P ≥ .09).
Discussion:
Higher BMI was associated with poorer attention and executive function in male HF patients, especially those with severe obesity. These patients may therefore have more difficulties with the HF treatment regimen and may have poorer outcomes.
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