Evaluating depressive symptoms, BDNF Val66Met, and APOE-ε4 as moderators of response to computerized cognitive training in heart failure.
Susan J Pressler, Miyeon Jung, Bruno Giordani and 9 others
PMID 36805256WHAT IT FOUND
Depression severity, BDNF Val66Met, and APOE-ε4 did not predict response to computerized cognitive training in heart failure.
The trial's memory and daily function outcomes improved over time in all groups.
Key findings
01Depression severity, BDNF Val66Met, and APOE-ε4 did not significantly moderate response to computerized cognitive training in heart failure.
02Gender, global cognitive function, age, and heart failure severity did not significantly moderate response in post hoc analyses.
03In the parent trial, delayed recall memory, working memory, daily activities, and health-related quality of life improved over time in all groups, while serum BDNF decreased over time.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for RNs
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What it does not show
This paper is a moderation analysis of a parent randomized trial whose main outcomes were not significant, so it cannot show that computerized cognitive training improves memory or daily function. Missing data were substantial at 8 months for working memory, daily activities, and serum BDNF because of COVID-19 restrictions. More patients with NYHA class 3 heart failure were randomized to the training and puzzles groups than to usual care, which may have influenced comparisons. Only 243 of 256 patients had blood available for genotyping. Adherence was low in some groups: 42 of 85 training patients met the 90% adherence rate. The nurse telephone support was given to all groups, so the paper cannot separate its contribution from the computerized interventions.
The easy way to misread this
Do not conclude that computerized cognitive training is ineffective for all heart failure patients because these moderators were null. This analysis tested whether depression severity, BDNF Val66Met, or APOE-ε4 predicted response. It did not establish that the training itself worked or did not work for everyone.