Examination of attention, executive function, and memory as predictors of mortality risk in adults with systolic heart failure.
Emily C Gathright, Mary A Dolansky, John Gunstad and 3 others
PMID 31342781WHAT IT FOUND
In adults with systolic heart failure, better overall thinking, attention, and planning were linked with lower death risk over nearly three years.
Memory was not linked. Screening these areas may identify patients needing closer self-management support.
Key findings
01After adjustment for age, sex, comorbidity, depressive symptoms, and heart failure class, better global cognitive function, attention, and executive function were each associated with lower all-cause mortality risk.
02Memory was not associated with all-cause mortality in unadjusted analysis.
03Older age, male sex, and higher depressive symptom scores were associated with higher mortality risk in the adjusted model.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was an observational cohort analysis, so it shows association and does not prove that cognitive impairment causes mortality or that treating cognition changes survival. The final sample was 325 of 372 enrolled in the parent study, after withdrawals and listwise deletion for missing data. The sample excluded people with neurological disease, dementia, psychiatric disorders, renal failure requiring dialysis, untreated sleep apnea, substance abuse, and NYHA class IV at entry, so it may not apply to more severe or more comorbid heart failure. Most participants had NYHA class II to III heart failure, and the sample had relatively low rates of cognitive impairment, which may limit generalizability. Cognitive function was measured at baseline only, so the study did not examine whether changes in cognition over time predict mortality. No neuroimaging or other physiologic measures were collected, so the mechanisms behind the associations are unclear. Memory impairment was uncommon (5.8%), so a null memory finding may reflect low prevalence in this sample.
Declared interests
The supplied publication types list NIH extramural research support, and the authors declared no conflict of interest.
The easy way to misread this
Do not conclude that improving attention or executive function will lower mortality. The study only measured baseline cognition and mortality in a selected cohort, and it did not test any treatment.