Cardiac rehabilitation is associated with lasting improvements in cognitive function in older adults with heart failure
Cardiac rehabilitation is associated with lasting improvements in cognitive function in older adults with heart failure
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DOI：
10.1080/ac.69.4.3036657
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发表时间：
2014-08-01
影响因子：
1.6
通讯作者：
Gunstad, John
中科院分区：
文献类型：
--
作者：
Alosco, Michael L.;Spitznagel, Mary Beth;Gunstad, John
目的心力衰竭（HF）是认知功能损害的危险因素。心脏康复（CR）可以通过改善身体健康（认知功能的重要促进因素）来减轻HF患者的不良神经认知结局。然而，没有研究已经检查了可能的急性和持久的好处CR对认知功能的人与HF.Methods和结果52例HF患者完成了为期12周的第二阶段CR程序。所有参与者都接受了神经心理学测试，并在基线、完成CR（即12周）和12个月随访时完成了简短的身体健康评估。重复测量分析显示，注意/执行功能和记忆的时间效应显著（P < 0.05）。注意力/执行功能表现从基线到12周增加，这些增益保持到12个月;记忆从基线到12周没有变化，但在12周至12个月的时间点之间有所改善。从基线到12周，身体健康得到改善，这些益处在12个月后得到维持。随着时间的推移，体能和认知功能的变化没有达到一个统计学上显着的关联，虽然较差的体能与认知性能下降在基线和12个月的时间points.Conclusions CR与急性和持久的认知功能的好处在HF患者。需要进行前瞻性研究和长期随访，以阐明CR后认知改善的机制（例如，改善脑灌注），以及CR是否可以最终降低认知能力下降和HF中阿尔茨海默病等疾病的风险。
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.Methods and 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.