title: Cardiovascular fitness associated with cognitive performance in heart failure patients enrolled in cardiac rehabilitation.
abstract: BACKGROUND
  Reduced cognitive function is common in persons with heart failure (HF). Cardiovascular fitness is a known contributor to cognitive function in many patient populations, but has only been linked to cognition based on estimates of fitness in HF. The current study examined the relationship between fitness as measured by metabolic equivalents (METs) from a standardized stress test and cognition in persons with HF, as well as the validity of office-based predictors of fitness in this population.
  
  
  METHODS
  Forty-one HF patients enrolled in cardiac rehabilitation completed a standardized exercise stress test protocol, a brief neuropsychological battery, the 2-minute step test (2MST), and a series of medical history and self-report questionnaires.
  
  
  RESULTS
  Maximum METs from stress testing demonstrated incremental predictive validity for attention (β = .41, p = .03), executive function (β = .37, p = .04), and memory domains (β = .46, p = .04). Partial correlations accounting for key medical and demographic characteristics revealed greater METs was associated with the 2MST (r(32) = .41, p = .02) but not with the Duke Activity Status Index (DASI) (r(32) = .24, p = .17).
  
  
  CONCLUSIONS
  The current findings indicate that better fitness levels measured by METs is independently associated with better cognitive function in older adults with HF. Results also showed that METs was closely associated with one office-based measure of fitness (2MST), but not another (DASI). Prospective studies are needed to clarify the mechanisms linking fitness and cognitive function in HF.
authors.affiliation: Department of Psychology, Kent State University, Kent, OH 44242, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Garcia
authors.forename: Michael L
authors.initials: ML
authors.lastname: Alosco
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Spitznagel
authors.forename: Ronald
authors.initials: R
authors.lastname: Cohen
authors.forename: Naftali
authors.initials: N
authors.lastname: Raz
authors.forename: Lawrence
authors.initials: L
authors.lastname: Sweet
authors.forename: Richard
authors.initials: R
authors.lastname: Josephson
authors.forename: Joel
authors.initials: J
authors.lastname: Hughes
authors.forename: Jim
authors.initials: J
authors.lastname: Rosneck
authors.forename: Morgan L
authors.initials: ML
authors.lastname: Oberle
authors.forename: John
authors.initials: J
authors.lastname: Gunstad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001288:Attention; D003071:Cognition; D056344:Executive Function; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D010809:Physical Fitness; D011237:Predictive Value of Tests; D057566:Self Report; D016896:Treatment Outcome