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About 5.7 million adults in the United States have heart failure (HF). One in nine deaths in 2009 included HF as contributing cause, and about half of those who develop HF die within five years of diagnosis. HF is associated with frequent hospital admissions, reduced quality of life, significant morbidity, and increased mortality.
Cognitive impairment is a common adverse consequence of HF and is characterized by deficits in one or more cognition domains, including attention, memory, executive function, and psychomotor speed. These deficits may affect patients' decision-making capacity and interfere with their ability to comply with treatment requirements as well as recognize and self-manage disease worsening symptoms.
The incidence of cognitive impairment varies widely from 25% to about 70%-80%, depending on the characteristics of the sample and of the disease, instruments used to assess cognition, and study design.
Research presented at EuroHeartCare 2019, a scientific congress of the European Society of Cardiology, indicates that two-thirds of patients with heart failure have cognitive problems. According to Professor Ercole Vellone of the University of Rome Tor Vergata, although it has previously been shown that HF should be treated with diet and exercise to improve quality of life and length of life, there is no direct evidence that physical activity improves cognition.
Professor Vellone and colleagues used data from the HF-Wii study, which enrolled 605 HF patients (average age, 67 years, 71% male) from six countries. The Montreal Cognitive Assessment test was used to measure cognitive function, and exercise capacity was measured with the six-minute walk test.
HF patients who walked further in a six-minute test, which shows better fitness, as well as those who were younger and more highly educated, were significantly less likely to have cognitive impairment. The results suggest that fitter patients have healthier brain function.
According to Vellone, there is a misconception that patients with HF should not exercise. However, Vellone recommends that patients find an activity that they enjoy and can do regularly, whether walking, swimming, or any number of activities.
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Dorothy L. Tengler, MA, is a freelance medical writer/communication specialist with nearly 20 years of experience in the pharmaceutical and medical communication industries. She has developed educational and medical marketing materials, including monographs, slide kits, health articles, primary and review manuscripts, and pharmaceutical sales training materials.