Computerized Cognitive Training and 24-Month Mortality in Heart Failure.
Miyeon Jung, Asa B Smith, Bruno Giordani and 5 others
PMID 37494830WHAT IT FOUND
In heart failure, computerized cognitive training did not reduce 24-month mortality.
Worse baseline cognition, memory, older age, and more depressive symptoms predicted death, but the training itself did not.
Key findings
01Computerized cognitive training did not significantly reduce 24-month all-cause mortality compared with combined control groups.
02Worse baseline global cognition and memory independently predicted higher 24-month mortality.
03Only 16 deaths occurred among 142 patients, limiting ability to detect a mortality effect.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 16 deaths occurred among 142 patients, so the study had limited ability to detect a mortality difference and could not use more complex multivariate models. Adherence to the cognitive training was low: 14 of 48 patients in the CCT group were adherent. The follow-up sample was a subset of the parent RCT, and original RCT characteristics, including stratification by cognition and gender, may influence results in unknown ways. Patients were recruited from specialty cardiology clinics, had stage C HF, NYHA class I to III, were receiving optimal medical therapies, and were excluded if MoCA was below 19 or if they had life-limiting illness; stage D HF were excluded. The sample had high education (mean 14.4 years) and mean age 64.6 years, which may limit generalizability to older or less educated heart failure populations.
Declared interests
The supplied text does not report an author conflict-of-interest declaration. It states the parent RCT was supported by NIH R01 NR016116-S, and the BrainHQ software was developed by PositScience.
The easy way to misread this
Do not conclude that computerized cognitive training improves survival in heart failure. The primary mortality outcome was null, and only 16 deaths occurred, so the study was limited in detecting a mortality effect. The significant baseline cognition, memory, age, and depressive symptom findings are predictors, not evidence that training changes mortality.