Anxiety, Depression, and Cognitive Function in Individuals with Co-morbid Heart Failure and Mild Cognitive Impairment: An Exploratory Analysis.
Time: -Topics: Mental Health, Cardiovascular Disease
Introduction: Although depression, anxiety, and cognitive impairment are common heart failure (HF) comorbidities, whether psychological distress can affect cognitive function in individuals with comorbid HF and cognitive impairment has not been explored. Studying these relationships can support the integration of anxiety or depression treatments into HF care to mitigate cognitive decline.
Aim: To examine associations between anxiety and depressive symptoms with cognitive function in patients with comorbid HF and mild cognitive impairment (MCI).
Hypotheses: Higher anxiety and depressive symptoms will be associated with lower cognitive function.
Methods: This is a secondary analysis of baseline data from the Mind Your Heart Study (MYHS), an ongoing randomized clinical trial of mindfulness training for patients with HF and MCI. MCI was defined as a Montreal Cognitive Assessment (MoCA) score of 15 to 26 (< 15 = moderate to severe cognitive impairment, > 26 = normal cognitive function). The Hospital Anxiety and Depression Scale was used to collect information on symptoms of anxiety (HADS-A) and depression (HADS-D). Scores ≥ 8 indicate clinically meaningful symptoms. Linear regression models assessed the relationship between HADS and MoCA scores.
Results: Patients (n = 68; age = 72 ± 13) were 44% female and 75% White. The mean baseline HADS-A score was 5.7 ± 3.7 (28% of patients had scores ≥ 8), HADS-D was 4.8 ± 3.2 (18% of patients had scores ≥ 8), and MoCA was 22 ± 3.0. Modest correlations were found between MoCA and age (r = -.21; 95% CI: -.44, .06; p = .09) as well as socioeconomic status (r = .17; 95% CI: -.08, .41; p = .16). Education, gender, and marital status covariates were not significantly associated with MoCA. HADS-A (β = .06; 95% CI = -.14, .25; p = .10) and HADS-D scores (β = -.02; 95% CI = -.24, .21; p = .11) were not associated with cognitive function in models controlling for age and socioeconomic status.
Conclusion: Anxiety or depressive symptoms were not associated with cognitive function in this sample of patients with comorbid HF and MCI. Limited MoCA variability due to the MYHS’s exclusion criteria could explain these findings. Further, the MoCA includes domains likely unaffected by mood; focusing on each cognitive domain (vs. the total MoCA score) may bring forth different results. Future studies should investigate this association in a more cognitively diverse population using more comprehensive cognitive assessments.
Keywords: Anxiety, DepressionAim: To examine associations between anxiety and depressive symptoms with cognitive function in patients with comorbid HF and mild cognitive impairment (MCI).
Hypotheses: Higher anxiety and depressive symptoms will be associated with lower cognitive function.
Methods: This is a secondary analysis of baseline data from the Mind Your Heart Study (MYHS), an ongoing randomized clinical trial of mindfulness training for patients with HF and MCI. MCI was defined as a Montreal Cognitive Assessment (MoCA) score of 15 to 26 (< 15 = moderate to severe cognitive impairment, > 26 = normal cognitive function). The Hospital Anxiety and Depression Scale was used to collect information on symptoms of anxiety (HADS-A) and depression (HADS-D). Scores ≥ 8 indicate clinically meaningful symptoms. Linear regression models assessed the relationship between HADS and MoCA scores.
Results: Patients (n = 68; age = 72 ± 13) were 44% female and 75% White. The mean baseline HADS-A score was 5.7 ± 3.7 (28% of patients had scores ≥ 8), HADS-D was 4.8 ± 3.2 (18% of patients had scores ≥ 8), and MoCA was 22 ± 3.0. Modest correlations were found between MoCA and age (r = -.21; 95% CI: -.44, .06; p = .09) as well as socioeconomic status (r = .17; 95% CI: -.08, .41; p = .16). Education, gender, and marital status covariates were not significantly associated with MoCA. HADS-A (β = .06; 95% CI = -.14, .25; p = .10) and HADS-D scores (β = -.02; 95% CI = -.24, .21; p = .11) were not associated with cognitive function in models controlling for age and socioeconomic status.
Conclusion: Anxiety or depressive symptoms were not associated with cognitive function in this sample of patients with comorbid HF and MCI. Limited MoCA variability due to the MYHS’s exclusion criteria could explain these findings. Further, the MoCA includes domains likely unaffected by mood; focusing on each cognitive domain (vs. the total MoCA score) may bring forth different results. Future studies should investigate this association in a more cognitively diverse population using more comprehensive cognitive assessments.
Authors and Affliiates
Co-Author: Danusha Selva Kumar, PhD, Alpert Medical School at Brown UniversityCo-Author: Christopher Liu, Brown University Health Cardiovascular Institute, The Miriam Hospital
Co-Author: Emily Gathright, PhD, The Center for Behavioral and Preventive Medicine, The Miriam Hospital
Co-Author: Janice Tripolone, MS, MAT, Brown University Health Cardiovascular Institute, The Miriam Hospital
Co-Author: Christopher Breault, BS, Survey Research Center, Brown University, School of Public Health
Co-Author: Elena Salmoirago-Blotcher, MD, PhD, FSBM, Brown University Health Cardiovascular Institute, The Miriam Hospital
Anxiety, Depression, and Cognitive Function in Individuals with Co-morbid Heart Failure and Mild Cognitive Impairment: An Exploratory Analysis.
Category
Scientific > Rapid Communication Poster