Randomized Controlled Trial of a Cognitive Intervention to Improve Memory in Heart Failure

• Published in: Journal of cardiac failure 2022-04, Vol.28 (4), p.519-530
• Main Authors: Pressler, Susan J., Jung, Miyeon, Gradus-Pizlo, Irmina, Titler, Marita G., Smith, Dean G., Gao, Sujuan, Lake, Kittie Reid, Burney, Heather, Clark, David G., Wierenga, Kelly L., Dorsey, Susan G., Giordani, Bruno
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Brain-Derived Neurotrophic Factor; Cognition; cognitive dysfunction; computerized cognitive training; heart failure; Heart Failure - complications; Heart Failure - therapy; Humans; nurse-enhancement intervention; Quality of Life
• ISSN: 1071-9164; 1532-8414; 1532-8414
• DOI: 10.1016/j.cardfail.2021.10.008

•Randomized, controlled interventional trial in 256 patients with heart failure.•Measures: memory, working memory, instrumental activities of living, quality of life.•All treatment groups had significant improvements of cognitive measures over 8 months.•Computerized cognitive training did not significantly alter outcomes over controls.•Nurse enhancement and decreases in serum brain-derived neurotrophic factor were found. The objective of this 3-arm randomized controlled trial was to evaluate the efficacy of computerized cognitive training (CCT) in improving primary outcomes of delayed-recall memory and serum brain-derived neurotrophic factor (BDNF) levels; and the secondary outcomes were working memory, instrumental activities of daily living (IADLs) and health-related quality of life (HRQL) in patients with heart failure (HF). Patients (n = 256) were randomly assigned to 8 weeks of CCT using BrainHQ, computerized crossword puzzles active control intervention, and usual care. All patients received weekly nurse-enhancement interventions. Data were collected at enrollment and baseline visits and at 10 weeks and 4 and 8 months. In mixed effects models, there were no statistically significant group or group-by-time differences in outcomes. There were statistically significant differences over time in all outcomes in all groups. Patients improved over time on measures of delayed-recall memory, working memory, IADLs, and HRQL and had decreased serum BDNF. CCT did not improve outcomes compared with the active control intervention and usual care. Nurse-enhancement interventions may have led to improved outcomes over time. Future studies are needed to test nurse-enhancement interventions in combination with other cognitive interventions to improve memory in persons with HF. [Display omitted]