title: Obesity interacts with cerebral hypoperfusion to exacerbate cognitive impairment in older adults with heart failure.
abstract: BACKGROUND
  Cerebral hypoperfusion accompanies heart failure (HF) and is associated with reduced cognitive performance. Obesity is prevalent in persons with HF and is also a likely contributor to cognitive function, as it has been independently linked to cognitive impairment in healthy individuals. The current study examined the association between obesity and cognitive performance among older adults with HF and whether obesity interacts with cerebral hypoperfusion to exacerbate cognitive impairment.
  
  
  METHODS
  Patients with HF (n = 99, 67.46 ± 11.36 years of age) completed neuropsychological testing and impedance cardiography. Cerebral blood flow velocity (CBF-V) measured by transcranial Doppler sonography quantified cerebral perfusion and body mass index (BMI) operationalized obesity.
  
  
  RESULTS
  A hierarchical regression analysis showed that lower CBF-V was associated with reduced performance on tests of attention/executive function and memory. Elevated BMI was independently associated with reduced attention/executive function and language test performance. Notably, a significant interaction between CBF-V and BMI indicated that a combination of hypoperfusion and high BMI has an especially adverse influence on attention/executive function in HF patients.
  
  
  CONCLUSIONS
  The current findings suggest that cerebral hypoperfusion and obesity interact to impair cognitive performance in persons with HF. These results may have important clinical implications, as HF patients who are at high risk for cerebral hypoperfusion may benefit from weight reduction.
authors.affiliation: Department of Psychology, Kent State University, Kent, Ohio, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Alosco
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Spitznagel
authors.forename: Naftali
authors.initials: N
authors.lastname: Raz
authors.forename: Ronald
authors.initials: R
authors.lastname: Cohen
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Sweet
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Colbert
authors.forename: Richard
authors.initials: R
authors.lastname: Josephson
authors.forename: Manfred
authors.initials: M
authors.lastname: van Dulmen
authors.forename: Joel
authors.initials: J
authors.lastname: Hughes
authors.forename: Jim
authors.initials: J
authors.lastname: Rosneck
authors.forename: John
authors.initials: J
authors.lastname: Gunstad