title: Greater body mass index is associated with poorer cognitive functioning in male heart failure patients.
abstract: BACKGROUND
  Heart failure (HF) and obesity are associated with cognitive impairment. However, few studies have investigated the relationship between adiposity and cognitive functioning in HF for each sex, despite observed sex differences in HF prognosis. We tested the hypothesis that greater body mass index (BMI) would be associated with poorer cognitive functioning, especially in men, in sex-stratified analyses.
  
  
  RESULTS
  Participants were 231 HF patients (34% female, 24% nonwhite, average age 68.7 ± 7.3 years). Height and weight were used to compute BMI. A neuropsychology battery tested global cognitive function, memory, attention, and executive function. Composites were created using averages of age-adjusted scaled scores. Regressions adjusting for demographic and medical factors were conducted. The sample was predominantly overweight/obese (76.2%). For men, greater BMI predicted poorer attention (ΔR(2) = 0.03; β = -0.18; P = .01) and executive function (ΔR(2) = 0.02; β = -0.13; P = .04); these effects were largely driven by men with severe obesity (BMI ≥40 kg/m(2)). BMI did not predict memory (P = .69) or global cognitive functioning (P = .08). In women, greater BMI was not associated with any cognitive variable (all P ≥ .09).
  
  
  CONCLUSIONS
  Higher BMI was associated with poorer attention and executive function in male HF patients, especially those with severe obesity. These patients may therefore have more difficulties with the HF treatment regimen and may have poorer outcomes.
authors.affiliation: Department of Psychology, Kent State University, Kent, Ohio. Electronic address: mhawki15@kent.edu.
authors.forename: Misty A W
authors.initials: MA
authors.lastname: Hawkins
authors.affiliation: Department of Psychology, Kent State University, Kent, Ohio.
authors.forename: John
authors.initials: J
authors.lastname: Gunstad
authors.affiliation: School of Nursing, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Dolansky
authors.affiliation: Department of Psychiatry, Summa Health System, Akron City Hospital, Akron, Ohio.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Redle
authors.affiliation: School of Medicine, Case Western Reserve University, Cleveland, Ohio; Harrington Heart & Vascular Institute, University Hospitals, Cleveland, Ohio.
authors.forename: Richard
authors.initials: R
authors.lastname: Josephson
authors.affiliation: School of Nursing, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Shirley M
authors.initials: SM
authors.lastname: Moore
authors.affiliation: Department of Psychology, Kent State University, Kent, Ohio; Department of Psychiatry, Summa Health System, Akron City Hospital, Akron, Ohio.
authors.forename: Joel W
authors.initials: JW
authors.lastname: Hughes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*
keywords: Attention; executive function; gender differences; obesity