title: Reduced cognitive function predicts functional decline in patients with heart failure over 12 months.
abstract: BACKGROUND
  Occurrences of impaired activities of daily living (ADL) are common in heart failure (HF) patients and contribute to the elevated mortality and hospitalization rates in this population. Cognitive impairment is also prevalent in HF, though its ability to predict functional decline over time is unknown.
  
  
  OBJECTIVE
  This study examined the longitudinal pattern of activities of daily living (ADL) in HF persons and whether reduced baseline cognitive status predicts functional decline in this population.
  
  
  METHODS
  Altogether 110 persons with HF completed the Lawton-Brody Instrumental Activities of Daily Living (IADL) scale and were administered the Modified Mini-Mental Status Examination (3MS) at baseline and a 12-month follow-up. Three composite scores were derived from the Lawton-Brody scale, including total, instrumental, and basic ADL.
  
  
  RESULTS
  HF patients reported high rates of baseline impairments in instrumental ADL, including shopping, food preparation, housekeeping duties, laundry, among others. Repeated measures analyses showed significant declines in total and instrumental ADL from baseline to the 12-month follow-up in HF (p<0.05). Hierarchical regression analyses showed that poorer baseline performance on the 3MS predicted worse total ADL performance at 12-months (β=0.15, p=0.049), including greater dependence in shopping, driving, feeding, and physical ambulation (p<0.05 for all).
  
  
  CONCLUSIONS
  The current results show that HF patients report significant functional decline over a 12-month period and brief cognitive tests can identify those patients at highest risk for decline. If replicated, such findings encourage the use of cognitive screening measures to identify HF patients most likely to require assistance with ADL tasks.
authors.affiliation: Department of Psychology, Kent State University, USA Malosco@kent.edu.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Alosco
authors.affiliation: Department of Psychology, Kent State University, USA Department of Psychiatry, Akron City Hospital, USA.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Spitznagel
authors.affiliation: Center for Cognitive Aging and Memory, University of Florida, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Cohen
authors.affiliation: Department of Psychology, University of Georgia, USA.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Sweet
authors.affiliation: Department of Kinesiology, University of Wisconsin, USA.
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Colbert
authors.affiliation: University Hospitals Case Medical Center, USA Case Western Reserve University School of Medicine, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Josephson
authors.affiliation: Department of Psychology, Kent State University, USA Department of Psychiatry, Akron City Hospital, USA.
authors.forename: Joel
authors.initials: J
authors.lastname: Hughes
authors.affiliation: Department of Psychiatry, Akron City Hospital, USA.
authors.forename: Jim
authors.initials: J
authors.lastname: Rosneck
authors.affiliation: Department of Psychology, Kent State University, USA Department of Psychiatry, Akron City Hospital, USA.
authors.forename: John
authors.initials: J
authors.lastname: Gunstad
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: Heart failure; activities of daily living; cognitive function; functional decline