title: Cognitive Function and Self-Care in Patients with Chronic Heart Failure.
abstract: OBJECTIVE
  This study examined the association of cognitive function with self-care and major adverse cardiac events (MACE) among heart failure (HF) patients.
  
  
  METHODS
  In this prospective study, 86 outpatients with HF completed face-to-face interviews including neuropsychological testing to evaluate cognitive function and the use of the Self-Care of Heart Failure Index to measure self-care. Functional status was assessed with the New York Heart Association (NYHA) classification. Follow-up data on MACE were obtained at 24 months after enrollment.
  
  
  RESULTS
  Compared with the Korean norm values, more than half of the HF patients had cognitive deficits in global function (33.0%), immediate recall (65.1%), delayed recall memory (65.1%), and executive function (60.5%). Patients with symptomatic HF (≥NYHA class II) had the higher risk for substantially poor cognitive function in all areas of cognitive function than asymptomatic HF patients (NYHA class I, p<0.05). Most patients demonstrated poor self-care adequacy in maintenance (84.9%), management of symptoms (100%), and confidence (86.0%). After adjustment for age and gender, memory function was significantly associated with self-care confidence (odds ratio 1.41, 95% confidence interval 1.03-1.92, p=0.033). No relationship was found between cognition and self-care maintenance. There were 19 MACE's during the 24-month follow-up. Patients without MACE had a significantly higher global cognitive function (p=0.024), while no cognitive domains were significant predictors of MACE when adjusted for age and gender.
  
  
  CONCLUSIONS
  HF patients with memory loss have poorer self-care confidence. Studies are warranted to examine the functional implication of cognitive deficits and adverse outcomes in a larger sample.
authors.affiliation: College of Nursing, Gachon University, Incheon, Korea.
authors.forename: Jin Shil
authors.initials: JS
authors.lastname: Kim
authors.affiliation: College of Nursing, Hanyang University, Seoul, Korea.
authors.forename: Seon Young
authors.initials: SY
authors.lastname: Hwang
authors.affiliation: College of Nursing, Hanyang University, Seoul, Korea.
authors.forename: Jae Lan
authors.initials: JL
authors.lastname: Shim
authors.affiliation: Department of Cardiology, Chonnam National University, Gwangju, Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
keywords: Cognition; Heart failure; Outpatients; Self care