Cognitive function and self-care management in older patients with heart failure. (1st June 2014)

• Record Type: Journal Article
• Authors: Harkness, Karen; Heckman, George A; Akhtar-Danesh, Noori; Demers, Catherine; Gunn, Elizabeth; McKelvie, Robert S
• Is Part Of: European journal of cardiovascular nursing. Volume 13:Number 3(2014)
• Page Start: 277
• Page End: 284
• Publication Date: 2014-06-01
• Subjects: Self-care management -- heart failure -- cognitive function; Cardiovascular system -- Diseases -- Nursing -- Periodicals; Cardiovascular Diseases -- nursing -- Periodicals; Cardiology -- Periodicals; Nursing -- Periodicals; Vascular Diseases -- Periodicals; 610.7369105
• DOI: 10.1177/1474515113492603
• Languages: English
• ISSNs: 1474-5151

Abstract

Abstract: Aims: People with heart failure have difficulty with self-care management. We do not know if patients with heart failure have difficulty with self-care management due to underlying, mild cognitive impairment (MCI). The purpose of this study was to determine whether MCI, as identified on a simple screening tool, is significantly associated with self-care management in a sample of community dwelling older patients with heart failure. Methods and results: Using a cross-sectional design, heart failure patients ( n =100, mean age 72 SD 10 years) attending an outpatient heart failure clinic completed the Montreal Cognitive Assessment tool (MoCA), Self-Care in Heart Failure Index (SCHFI) and Geriatric Depression Scale. The presence of MCI, as defined by a MoCA score <26, was present in 73% patients; 21% had an adequate self-care management SCHFI score; and 12% reported symptoms of depression. Participants with a MoCA score <26 vs . ≥ 26 scored significantly lower on the self-care management subscale of the SCHFI (48.1 SD 24 vs . 59.3 SD 22 respectively, p =0.035). Using backward regression, the final model was fitted to self-care management while controlling for age and sex and was significant, with ( F = 7.04 df (3, 96), and p <0.001), accounting for 18% of the total variance in self-care management ( R 2 = 18.03%). The MoCA score was the only variable which remained in the model significantly with p = 0.001. Conclusion: Findings from this study highlight the difficulty older heart failure patients have with self-care management and the need to include formal screening for MCI when exploring variables contributing to self-care management in heart failure patients.