title: Reduced cerebral perfusion predicts greater depressive symptoms and cognitive dysfunction at a 1-year follow-up in patients with heart failure.
abstract: OBJECTIVE
  Cerebral hypoperfusion is common in heart failure (HF) and believed to underlie poor neurocognitive outcomes in this population. Up to 42% of HF patients also exhibit depressive symptomatology that may stem from reduced cerebral blood flow. However, no study has examined this possibility or whether reduced brain perfusion increases risk for future cognitive dysfunction in older adults with HF.
  
  
  METHODS
  One hundred HF patients underwent transcranial Doppler ultrasonagraphy to quantify global cerebral blood flow velocity (CBF-V) and were administered a cognitive test battery to assess global cognition, attention/executive function, and memory abilities. All participants then completed the Beck Depression Inventory-II to assess depressive symptomatology. These procedures were performed at baseline and at 12-month follow-up.
  
  
  RESULTS
  Repeated measures revealed that CBF-V declined over the 12-month period. Regression analyses showed that reduced baseline CBF-V predicted worse performances in attention/executive function (p < 0.05 for all) and a trend for memory (p = 0.09) in addition to greater depressive symptomatology (p < 0.05) at the 12-month follow-up, even after controlling for baseline factors and medical and demographic variables.
  
  
  CONCLUSIONS
  Cerebral perfusion declined over time and was associated with poorer cognitive function and greater depressive symptoms at a 1-year follow-up in HF. Prospective studies with long-term follow-ups that employ neuroimaging are needed to examine whether cognitive dysfunction and depression in HF stem from the adverse effects of cerebral hypoperfusion on the cerebral structure.
authors.affiliation: Department of Psychology, Kent State University, Kent, OH, USA.
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 H
authors.initials: LH
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: John
authors.initials: J
authors.lastname: Gunstad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology; D001783:Blood Flow Velocity; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000503:physiopathology*; D003866:Depressive Disorder / Q000503:physiopathology*; D056344:Executive Function / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis
keywords: cerebral blood flow; cognitive function; depression; heart failure
references.citation: J Card Fail. 2000 Dec;6(4):300-5
references.pmid: 11145754
references.citation: Cardiovasc Psychiatry Neurol. 2011;2011:368324
references.pmid: 22195274
references.citation: Health Psychol. 2001 Mar;20(2):112-9
references.pmid: 11315728
references.citation: Aging Male. 2011 Mar;14(1):59-65
references.pmid: 20873985
references.citation: J Neurol Neurosurg Psychiatry. 2002 Jul;73(1):34-9
references.pmid: 12082042
references.citation: Int J Geriatr Psychiatry. 2009 Aug;24(8):809-19
references.pmid: 19484709
references.citation: Int Psychogeriatr. 2006 Sep;18(3):445-56
references.pmid: 16478567
references.citation: Am J Med. 2003 Aug 1;115(2):97-103
references.pmid: 12893394
references.citation: J Am Coll Cardiol. 2006 Oct 17;48(8):1527-37
references.pmid: 17045884
references.citation: Stroke. 1986 Sep-Oct;17(5):913-5
references.pmid: 3764963
references.citation: Alzheimer Dis Assoc Disord. 2010 Jan-Mar;24(1):19-27
references.pmid: 20220321
references.citation: Transl Psychiatry. 2011 Aug 09;1:e28
references.pmid: 22832602
references.citation: Psychol Med. 2006 May;36(5):597-608
references.pmid: 16515732
references.citation: Biol Psychiatry. 2006 Dec 15;60(12):1304-5
references.pmid: 17157096
references.citation: Braz J Med Biol Res. 2005 Mar;38(3):431-6
references.pmid: 15761623
references.citation: J Neurol Sci. 2011 Aug 15;307(1-2):106-13
references.pmid: 21612797
references.citation: Am J Geriatr Psychiatry. 2002 Nov-Dec;10(6):687-95
references.pmid: 12427577
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: Cardiovasc Psychiatry Neurol. 2012;2012:367516
references.pmid: 23243502
references.citation: BMC Cardiovasc Disord. 2013 Apr 16;13:29
references.pmid: 23590224
references.citation: Arch Gen Psychiatry. 1997 Oct;54(10):915-22
references.pmid: 9337771
references.citation: Intern Med J. 2009 Sep;39(9):600-5
references.pmid: 19220544
references.citation: Psychosom Med. 2013 Sep;75(7):632-9
references.pmid: 23873714
references.citation: J Neuroimaging. 2005 Apr;15(2):150-6
references.pmid: 15746227
references.citation: Neurology. 2000 Dec 12;55(11):1621-6
references.pmid: 11113214
references.citation: Stroke. 2001 Nov;32(11):2530-3
references.pmid: 11692012
references.citation: Pediatr Radiol. 2000 Nov;30(11):733-8
references.pmid: 11100487
references.citation: Arch Neurol. 2008 Jul;65(7):963-7
references.pmid: 18625866
references.citation: J Cardiol. 2012 Jul;60(1):23-30
references.pmid: 22445598
references.citation: Behav Modif. 2008 Jan;32(1):3-20
references.pmid: 18096969
references.citation: J Clin Exp Neuropsychol. 2012;34(5):509-20
references.pmid: 22375800
references.citation: Neurobiol Aging. 2000 Mar-Apr;21(2):257-69
references.pmid: 10867210
references.citation: J Ultrasound Med. 2010 Jul;29(7):1017-22
references.pmid: 20587424
references.citation: Eur J Heart Fail. 2013 Aug;15(8):850-8
references.pmid: 23463084
references.citation: Congest Heart Fail. 2013 Jul-Aug;19(4):E29-34
references.pmid: 23517434
references.citation: J Am Coll Cardiol. 2013 Jan 29;61(4):391-403
references.pmid: 23219302
references.citation: Nurs Res. 2010 Mar-Apr;59(2):127-39
references.pmid: 20216015
references.citation: J Alzheimers Dis. 2010;20(3):813-21
references.pmid: 20413856
references.citation: Eur J Heart Fail. 2007 Oct;9(10):1003-9
references.pmid: 17719270