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
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
Alosco, Michael L; Spitznagel, Mary Beth; Cohen, Ronald et al. (2014) Decreases in body mass index after cardiac rehabilitation predict improved cognitive function in older adults with heart failure. J Am Geriatr Soc 62:2215-6
Alosco, Michael L; Galioto, Rachel; Spitznagel, Mary Beth et al. (2014) Cognitive function after bariatric surgery: evidence for improvement 3 years after surgery. Am J Surg 207:870-6
Alosco, Michael L; Spitznagel, Mary Beth; Strain, Gladys et al. (2014) The effects of cystatin C and alkaline phosphatase changes on cognitive function 12-months after bariatric surgery. J Neurol Sci 345:176-80
Alosco, Michael L; Fedor, Andrew F; Gunstad, John (2014) Attention deficit hyperactivity disorder as a risk factor for concussions in NCAA division-I athletes. Brain Inj 28:472-4
Alosco, Michael L; Spitznagel, Mary Beth; Cohen, Ronald et al. (2014) Reduced cerebral perfusion predicts greater depressive symptoms and cognitive dysfunction at a 1-year follow-up in patients with heart failure. Int J Geriatr Psychiatry 29:428-36
Alosco, Michael L; Spitznagel, Mary Beth; Cohen, Ronald et al. (2014) Decreased physical activity predicts cognitive dysfunction and reduced cerebral blood flow in heart failure. J Neurol Sci 339:169-75
Rosneck, James S; Hughes, Joel; Gunstad, John et al. (2014) Development and psychometric evaluation of a cardiovascular risk and disease management knowledge assessment tool. J Cardiovasc Nurs 29:242-56
Spitznagel, Mary Beth; Alosco, Michael; Galioto, Rachel et al. (2014) The role of cognitive function in postoperative weight loss outcomes: 36-month follow-up. Obes Surg 24:1078-84
Alosco, Michael L; Stanek, Kelly M; Galioto, Rachel et al. (2014) Body mass index and brain structure in healthy children and adolescents. Int J Neurosci 124:49-55

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