This application is submitted in response to PAR-07-046 ?Research on Mind-Body Interactions and Health.? We are making application to prospectively examine the cognitive effects of cardiac rehabilitation (CR) in patients with heart failure (HF). Despite advances in treatment, more than 5 million Americans have HF and 500,000 more develop HF each year. Neurocognitive deficits are found in up to 80 percent of HF patients and these deficicts are independent predictors of disability and mortality. This risk has been attributed to difficulty adhering to the prescribed medical regimen, which exacerbates HF symptoms. There is reason to believe that participation in CR may improve cognitive function in HF patients. CR provides many benefits to HF patients, including decreased severity of cardiac symptoms, improved functional abilities, and better quality of life. Preliminary work from our lab and others indicates that CR also improves cerebral blood flow and autonomic nervous system (ANS) function, factors that are associated with cognitive function in HF patients. Little is known about the possible cognitive benefits of CR in HF patients. The proposed study will examined cognitive function in 100 HF patients that participate in CR and 100 demographically- and medically-similar HF patients that do not. HF patients will undergo primary assessment at enrollment, 12 week completion of CR, and 12 month follow-up. Primary assessments will include measures of cardiac performance, ANS function, cerebral blood flow, physical function/activity, and cognitive function. Remote assessment of physical activity will also be completed at 6 and 9 month follow-up. Control participants will complete assessments at identical intervals. Finally, a subset of participants (70 in each group) will undergo magnetic resonance imaging at the primary assessments to determine the contribution of structural brain changes to cognitive function. Findings from the proposed study will provide important information regarding: 1) the possible cognitive benefits of CR;2) mechanisms for these benefits;and 3) the relationship between cognitive function and treatment adherence and psychosocial outcomes. Cognitive dysfunction is found in up to 80% of heart failure patients and is an independent predictor of disability and mortality. The proposed project will clarify the etiology and reversibility of cognitive dysfunction in persons with heart failure.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL089311-04
Application #
8096746
Study Section
Special Emphasis Panel (ZRG1-RPHB-K (03))
Program Officer
Stoney, Catherine
Project Start
2008-09-15
Project End
2013-11-30
Budget Start
2011-12-01
Budget End
2013-11-30
Support Year
4
Fiscal Year
2012
Total Cost
$658,430
Indirect Cost
$283,504
Name
Kent State University at Kent
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
041071101
City
Kent
State
OH
Country
United States
Zip Code
44242
Rochette, Amber D; Spitznagel, Mary Beth; Sweet, Lawrence H et al. (2016) Gender Differences in Cognitive Test Performance in Adults With Heart Failure. J Cardiovasc Nurs :
Alosco, Michael L; Brickman, Adam M; Spitznagel, Mary Beth et al. (2016) Reduced Gray Matter Volume Is Associated With Poorer Instrumental Activities of Daily Living Performance in Heart Failure. J Cardiovasc Nurs 31:31-41
Alosco, Michael L; Spitznagel, Mary Beth; Sweet, Lawrence H et al. (2015) Cognitive dysfunction mediates the effects of poor physical fitness on decreased functional independence in heart failure. Geriatr Gerontol Int 15:174-81
Daiello, Lori A; Gongvatana, Assawin; Dunsiger, Shira et al. (2015) Association of fish oil supplement use with preservation of brain volume and cognitive function. Alzheimers Dement 11:226-35
Alosco, Michael L; Spitznagel, Mary Beth; Strain, Gladys et al. (2015) Improved serum leptin and ghrelin following bariatric surgery predict better postoperative cognitive function. J Clin Neurol 11:48-56
Garcia, Sarah; Calvo, Dayana; Spitznagel, Mary Beth et al. (2015) Dairy intake is associated with memory and pulsatility index in heart failure. Int J Neurosci 125:247-52
Alosco, Michael L; Spitznagel, Mary Beth; Josephson, Richard et al. (2015) COPD is associated with cognitive dysfunction and poor physical fitness in heart failure. Heart Lung 44:21-6
Alosco, Michael L; Brickman, Adam M; Spitznagel, Mary Beth et al. (2015) Daily Physical Activity Is Associated with Subcortical Brain Volume and Cognition in Heart Failure. J Int Neuropsychol Soc 21:851-60
Alosco, Michael L; Spitznagel, Mary Beth; Cohen, Ronald et al. (2015) Obesity and cognitive dysfunction in heart failure: the role of hypertension, type 2 diabetes, and physical fitness. Eur J Cardiovasc Nurs 14:334-41
Alosco, Michael L; Spitznagel, Mary Beth; Sweet, Lawrence H et al. (2015) Atrial fibrillation exacerbates cognitive dysfunction and cerebral perfusion in heart failure. Pacing Clin Electrophysiol 38:178-86

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