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Better adherence to treatment recommendations in heart failure predicts improved cognitive function at a one-year
Michael L Alosco1, Mary Beth Spitznagel, Ronald Cohen
1a Department of Psychological Sciences , Kent State University , Kent , OH , USA.
Insights
Treatment adherence in heart failure (HF) patients predicts better cognitive function over time. This suggests that improving adherence may help preserve cognitive abilities in individuals with HF.
Area of Science:
- Cardiology
- Neuropsychology
- Public Health
Background:
- Treatment nonadherence is prevalent in heart failure (HF) patients, negatively impacting health outcomes.
- Cognitive function is recognized as a determinant of treatment adherence, but the reverse relationship is less understood.
- This study investigated whether treatment adherence predicts cognitive function changes in HF patients.
Purpose of the Study:
- To examine the predictive relationship between treatment adherence and cognitive function in heart failure patients.
- To determine if adherence to medication, diet, and lifestyle modifications influences cognitive performance over time.
Main Methods:
- 115 heart failure patients self-reported treatment adherence.
- Cognitive function was assessed using the Modified Mini Mental State Examination (3MS), Trail Making Test, and California Verbal Learning Test-II (CVLT-II).
- Assessments were conducted at baseline and after a 12-month follow-up period.
Main Results:
- Global cognition and memory improved significantly in HF patients over 12 months.
- Higher baseline treatment adherence predicted better 12-month cognitive performance on the 3MS and CVLT-II.
- Adherence to medication and diet, along with smoking abstinence, were key predictors of cognitive improvement.
Conclusions:
- Better treatment adherence is associated with improved cognitive function one year later in heart failure patients.
- Findings suggest that adherence may play a role in preserving cognitive function in this population.
- Further research with objective adherence measures is recommended to confirm these results.
Introduction:
Treatment nonadherence is common in heart failure (HF) and is associated with poor health outcomes in this population. Recent cross-sectional work in heart failure and past work in other medical populations suggest that cognitive function is a key determinant of a patient's ability to adhere to treatment recommendations. However, it is also possible that treatment adherence is an important modifier and predictor of cognitive function, though no study has examined this possibility, and we sought to do so in a sample of heart failure patients.
Method:
A total of 115 patients with heart failure self-reported adherence to treatment recommendations. The Modified Mini Mental State Examination (3MS), Trail Making Test Parts A and B, and the California Verbal Learning Test-II (CVLT-II) assessed cognitive function. These procedures were performed at baseline and a 12-month follow-up.
Results:
Global cognition and memory abilities improved over the 12-month period. Regression analyses controlling for baseline and medical and demographic factors showed that better baseline treatment adherence predicted improved 12-month performances on the 3MS and CVLT-II. Adherence to medication and diet regimens and smoking abstinence emerged as the most important contributors.
Conclusions:
Better treatment adherence predicted improved cognition one year later in HF. Prospective studies that utilize objective assessments of treatment adherence are needed to confirm our findings and examine whether improved treatment adherence preserves cognitive function in heart failure.
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