Predictors of Neuropsychological Status in Cardiac Patients

Abstract

Heart Disease is one of the leading causes of death and disability in the United States. Disease processes such as Coronary Artery Disease (CAD) and Chronic Heart Failure (CHF) account for the majority of cases, and are responsible for Myocardial Infarctions (MI), Coronary Artery Bypass Grafting (CABG) surgery, and other common disease sequelae and treatment paradigms. While the fact that heart can negatively impact cognitive functioning is well documented, the factors that drive changes in cognition have not been studied in depth. Additionally, while many heart patients choose to enter cardiac rehabilitation (CR) programs designed to decrease morbidly and mortality, most do not. This study used hierarchical regression models to test these two aims. heart patients entering rehabilitation or electing not to participate were assessed using a chart review, standardized neuropsychological measures, and standard questionnaires, with a final sample size of 52 (11 controls, 41 rehabilitation subjects). For Aim 1, health (hypertension, CHF, surgery history), and cognitive reserve (education, premorbid IQ) variables successfully predicted the cognitive status of heart patients across several functional domains, while affective factors (depression, anxiety, stress) were less predictive. For Aim 2, cognitive variables were not significantly associated with whether or not a patient adheres to cardiac rehabilitation. Results indicate that multiple health and cognitive reserve-related factors impact cognitive functioning. Helping heart patients manage or compensate for identified risk factors could help mediate morbidity and mortality