Interplay of cognitive functions and functional status in heart failure
Fernanda Laís Loro, Gisele Agustini Lovatel, Gênifer Parise, Fernanda Lange Coelho, Mariele Munhoz Rodrigues Alvares, Naira Helena Bohrer Scherer, Lucas Capalonga, Isadora Faraco Corrêa, Maria Luísa Rocha Dadalt, Pedro Dal Lago
Resumo
Background: Heart failure (HF) reduces functional status, which may be linked to cognitive decline. Understanding the impact of cognitive function is essential for disease management, as it requires significant patient comprehension to ensure effective treatment and to influence daily activities. Aim: To assess how episodic memory and executive function contribute to functional status in daily life activities in HF patients. Methods: The study used a cross-sectional design with an age-matched control group. The convenience sample consisted of patients with HF (independent of left ventricular ejection fraction) and healthy volunteers age-matched in the control group from the community. Data was collected from April to December 2018. We utilized Rey’s Auditory Verbal Learning Test, Trail Making Tests (TMT A and B), Glittre Activities of Daily Living test (Glittre-ADL), and Instrumental Activities of Daily Living Scale to measure episodic memory, executive function, functional status in daily living and functional dependence, respectively. Results: We recruited 57 participants (HF=37; Control=20). Five HF patients were excluded because they did not complete all tests. HF patients exhibited a prolonged duration to complete the Glittre-ADL test compared to controls (287.9 ± 91.2 vs. 212.7 ± 34.9 seconds; p < 0.001). Episodic memory scores did not significantly differ between the groups. However, as measured by the TMT, the HF group’s executive function was notably poorer. Regression analysis revealed that HF and executive function (TMT A and B) significantly impacted functional status, explaining 24.1% of the variance (R2 = 0.241, p < 0.001). In a second regression model (HF, TMT-A, TMT-B, and age), HF (p=0.001) and age (p=0.009) were significant. The variance in the functional status was 27.3% (R2= 0.273), attributable to the variables HF and age. Conclusion: In conclusion, our results have revealed that the compromised executive function can partly explain the decline in performance on the ADL-Glittre test in HF patients. Moreover, when age was included in the model, the performance on the ADL-Glittre test was significantly associated with both age and HF.
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Referências
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Submetido em:
01/12/2023
Aceito em:
12/04/2024
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