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Cognitive Function Predicts Risk for Clinically Significant Weight Gain in Adults With Heart Failure
Mary A Dolansky1, Misty A W Hawkins, Julie T Schaefer
1Mary A. Dolansky, PhD, RN Associate Professor, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. Misty A.W. Hawkins, PhD Assistant Professor, Department of Psychology, Oklahoma State University, Stillwater. Julie T. Schaefer, PhD, RD Research Associate, Department of Psychological Sciences and Department of Psychology, Kent State University, Ohio. John Gunstad, PhD Professor, Department of Psychological Sciences, Kent State University, Ohio. Joseph D. Redle, MD Cardiologist, Cardiovascular Institute, Summa Health System, Akron City Hospital, Ohio. Abdus Sattar, PhD Associate Professor, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio. Anton Vehovec, BSN Research Associate, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. Richard Josephson, MD, MS Professor, School of Medicine, Case Western Reserve University, and Harrington Heart & Vascular Institute, University Hospitals, Cleveland, Ohio. Shirley M. Moore, PhD, RN Edward J. and Louise Mellen Professor of Nursing and Associate Dean for Research, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. Joel W. Hughes, PhD Professor, Department of Psychological Sciences, Kent State University, and Cardiovascular Institute, Summa Health System, Akron City Hospital, Ohio.
Background:
Few investigators have examined whether cognitive deficits predict poorer self-care of weight management recommendations and weight gain in adults with heart failure.
Objective:
The purposes of this study were (1) to examine whether cognition is associated with adherence to daily weighing and weight gain incidence and (2) to explore self-reported symptom perception and management when a weight increase occurs.
Methods:
In this observational study, participants completed neuropsychological testing, were given an electronic scale, and were instructed to record their weight for 21 days. Data for 301 participants were collected at baseline and 3 weeks after weight monitoring.
Results:
At baseline, only 35% of the enrolled respondents knew when to call their physician for increased weight gain, and 37% of the analyzed sample (n = 110/301) experienced a clinically significant weight gain. Regressions tested whether baseline attention, executive function, or memory predicted adherence to daily weighing and the likelihood of weight gain incidence. In unadjusted and adjusted covariate analyses, none of the cognitive domains predicted adherence to daily weighing (P ≥ .375); however, all 3 cognitive domains predicted an increased risk of a clinically significant weight gain (P ≤ .05). Importantly, 65% of participants with a weight gain did not identify this symptom on self-report questions.
Conclusions:
Although cognitive deficits are not associated with adherence to daily weighing, adults with cognitive deficits may be at an increased risk for experiencing a clinically significant weight gain, and most do not perceive symptoms.
Clinical Implications:
Adults with heart failure require more than directions on self-care related to weight monitoring.
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