title: Decreased physical activity predicts cognitive dysfunction and reduced cerebral blood flow in heart failure.
abstract: OBJECTIVE
  Cognitive impairment in heart failure (HF) is believed to result from brain hypoperfusion subsequent to cardiac dysfunction. Physical inactivity is prevalent in HF and correlated with reduced cardiac and cognitive function. Yet, no longitudinal studies have examined the neurocognitive effects of physical inactivity in HF. The current study examined whether reduced physical activity increases risk for cognitive impairment and brain hypoperfusion over time in HF.
  
  
  METHODS
  At baseline and 12 months later, 65 HF patients underwent neuropsychological testing, transcranial Doppler ultrasonography, and were asked to wear an accelerometer for seven days.
  
  
  RESULTS
  Lower baseline step count and less time spent in moderate free-living activity best predicted worse attention/executive function and decreased cerebral perfusion at the 12-month follow-up. Decreased baseline cerebral perfusion also emerged as a strong predictor of poorer 12-month attention/executive function.
  
  
  CONCLUSIONS
  Lower physical activity predicted worse cognition and cerebral perfusion 12 months later in HF. Physical inactivity in HF may contribute to cognitive impairment and exacerbate risk for conditions such as Alzheimer's disease. Larger studies are needed to elucidate the mechanisms by which physical inactivity leads to cognitive dysfunction in HF, including clarification of the role of cerebral hypoperfusion.
authors.affiliation: Department of Psychology, Kent State University, Kent, OH, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Alosco
authors.affiliation: Department of Psychology, Kent State University, Kent, OH, USA.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Spitznagel
authors.affiliation: Department of Neurology, University of Florida, USA; Department of Psychiatry, University of Florida, USA; The Institute on Aging, Center for Cognitive Aging and Memory, University of Florida, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Cohen
authors.affiliation: Institute of Gerontology, Wayne State University, Detroit, MI, USA.
authors.forename: Naftali
authors.initials: N
authors.lastname: Raz
authors.affiliation: Department of Psychology, University of Georgia, Athens, USA.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Sweet
authors.affiliation: University Hospitals Case Medical Center and Department of Medicine, Cleveland, OH, USA; Harrington Heart & Vascular Institute, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Josephson
authors.affiliation: Department of Psychology, Kent State University, Kent, OH, USA; Cardiac Rehabilitation, Summa Health System, Akron City Hospital, Akron, OH, USA.
authors.forename: Joel
authors.initials: J
authors.lastname: Hughes
authors.affiliation: Cardiac Rehabilitation, Summa Health System, Akron City Hospital, Akron, OH, USA.
authors.forename: Jim
authors.initials: J
authors.lastname: Rosneck
authors.affiliation: Department of Psychology, Kent State University, Kent, OH, USA. Electronic address: jgunstad@kent.edu.
authors.forename: John
authors.initials: J
authors.lastname: Gunstad
mesh_terms: D061725:Accelerometry / Q000379:methods; D000368:Aged; D000369:Aged, 80 and over; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003072:Cognition Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011446:Prospective Studies; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods
keywords: Accelerometry; Cerebral blood flow; Cognitive function; Heart failure; Neuropsychology; Physical activity; Sedentary