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Better adherence to treatment recommendations in heart failure predicts improved cognitive function at a one-year follow-up

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 abilit...

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Published in:Journal of clinical and experimental neuropsychology 2014-10, Vol.36 (9), p.956-966
Main Authors: Alosco, Michael L., Spitznagel, Mary Beth, Cohen, Ronald, Sweet, Lawrence H., Josephson, Richard, Hughes, Joel, Rosneck, Jim, Gunstad, John
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cited_by cdi_FETCH-LOGICAL-c597t-2b6bc7b5392156c6eb1eb5820e561c3962306565a313d08a28d3d6bd1ade79373
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container_issue 9
container_start_page 956
container_title Journal of clinical and experimental neuropsychology
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creator Alosco, Michael L.
Spitznagel, Mary Beth
Cohen, Ronald
Sweet, Lawrence H.
Josephson, Richard
Hughes, Joel
Rosneck, Jim
Gunstad, John
description 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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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.</description><identifier>ISSN: 1380-3395</identifier><identifier>EISSN: 1744-411X</identifier><identifier>DOI: 10.1080/13803395.2014.957167</identifier><identifier>PMID: 25352233</identifier><language>eng</language><publisher>Hove: Routledge</publisher><subject>Adult and adolescent clinical studies ; Aged ; Aged, 80 and over ; Analysis of Variance ; Biological and medical sciences ; Cardiology. Vascular system ; Cognition Disorders - diagnosis ; Cognition Disorders - psychology ; Cognitive function ; Cross-Sectional Studies ; Depression - etiology ; Female ; Follow-Up Studies ; Heart ; Heart failure ; Heart Failure - complications ; Heart Failure - psychology ; Heart Failure - therapy ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Humans ; Longitudinal ; Male ; Medical sciences ; Mental Status Schedule ; Middle Aged ; Neuropsychological Tests ; Organic mental disorders. Neuropsychology ; Patient Compliance - psychology ; Predictive Value of Tests ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. 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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.</description><subject>Adult and adolescent clinical studies</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cognition Disorders - diagnosis</subject><subject>Cognition Disorders - psychology</subject><subject>Cognitive function</subject><subject>Cross-Sectional Studies</subject><subject>Depression - etiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart failure</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - psychology</subject><subject>Heart Failure - therapy</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Humans</subject><subject>Longitudinal</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental Status Schedule</subject><subject>Middle Aged</subject><subject>Neuropsychological Tests</subject><subject>Organic mental disorders. Neuropsychology</subject><subject>Patient Compliance - psychology</subject><subject>Predictive Value of Tests</subject><subject>Psychology. Psychoanalysis. 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Vascular system</topic><topic>Cognition Disorders - diagnosis</topic><topic>Cognition Disorders - psychology</topic><topic>Cognitive function</topic><topic>Cross-Sectional Studies</topic><topic>Depression - etiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Heart failure</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - psychology</topic><topic>Heart Failure - therapy</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Humans</topic><topic>Longitudinal</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental Status Schedule</topic><topic>Middle Aged</topic><topic>Neuropsychological Tests</topic><topic>Organic mental disorders. Neuropsychology</topic><topic>Patient Compliance - psychology</topic><topic>Predictive Value of Tests</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. 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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.</abstract><cop>Hove</cop><pub>Routledge</pub><pmid>25352233</pmid><doi>10.1080/13803395.2014.957167</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult and adolescent clinical studies
Aged
Aged, 80 and over
Analysis of Variance
Biological and medical sciences
Cardiology. Vascular system
Cognition Disorders - diagnosis
Cognition Disorders - psychology
Cognitive function
Cross-Sectional Studies
Depression - etiology
Female
Follow-Up Studies
Heart
Heart failure
Heart Failure - complications
Heart Failure - psychology
Heart Failure - therapy
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Humans
Longitudinal
Male
Medical sciences
Mental Status Schedule
Middle Aged
Neuropsychological Tests
Organic mental disorders. Neuropsychology
Patient Compliance - psychology
Predictive Value of Tests
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Regression Analysis
Self Report
Treatment adherence
title Better adherence to treatment recommendations in heart failure predicts improved cognitive function at a one-year follow-up
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