title: Cardiac rehabilitation is associated with lasting improvements in cognitive function in older adults with heart failure.
abstract: OBJECTIVE
  Heart failure (HF) is a known risk factor for cognitive impairment. Cardiac rehabilitation (CR) may attenuate poor neurocognitive outcomes in HF via improved physical fitness--a significant promoter of cognitive function. However, no study has examined the possible acute and lasting benefits of CR on cognitive function in persons with HF.
  
  
  RESULTS
  Fifty-two patients with HF completed a 12-week Phase II CR program. All participants were administered neuropsychological testing and completed a brief physical fitness assessment at baseline, completion of CR (i.e. 12 weeks), and 12-month follow-up. Repeated measures analyses showed a significant time effect for both attention/executive function and memory (P < 0.05). Attention/executive function performance increased from baseline to 12 weeks and these gains remained up to 12 months; memory was unchanged from baseline to 12 weeks, but then improved between the 12-week and 12-month time points. Physical fitness improved from baseline to 12 weeks and these benefits were maintained 12 months later. Changes in physical fitness and cognitive function over time did not reach a statistically significant association, though poorer physical fitness was associated with decreased cognitive performance at the baseline and 12-month time points.
  
  
  CONCLUSIONS
  CR is associated with both acute and lasting cognitive benefits in patients with HF. Prospective studies with extended follow-ups are needed to clarify the mechanisms that underpin cognitive improvements following CR (e.g., improved cerebral perfusion) and whether CR can ultimately reduce risk for cognitive decline and conditions like Alzheimer's disease in HF.
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: 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; D000375:Aging; D003072:Cognition Disorders / Q000209:etiology / Q000534:rehabilitation*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010809:Physical Fitness; D012307:Risk Factors; D012494:Sampling Studies