Title

What is Your Patient's Cognitive Profile? Three Distinct Subgroups of Cognitive Function in Persons with Heart Failure

Publication Title

Applied Nursing Research

Publication Date

2015

Document Type

Article

DOI

10.1016/j.apnr.2014.10.005

Keywords

cardiovascular disease, neuropsychological performance, cognitive profiles, older adults, cluster analysis

Disciplines

Health Psychology | Nursing | Psychology

Abstract

Purpose

The aim of this study was to determine whether patients with heart failure (HF) have distinct profiles of cognitive impairment.

Background

Cognitive impairment is common in HF. Recent work found three cognitive profiles in HF patients—(1) intact, (2) impaired, and (3) memory-impaired. We examined the reproducibility of these profiles and clarified mechanisms.

Methods

HF patients (68.6 ± 9.7 years; N = 329) completed neuropsychological testing. Composite scores were created for cognitive domains and used to identify clusters via agglomerative-hierarchical cluster analysis.

Results

A 3-cluster solution emerged. Cluster 1 (n = 109) had intact cognition. Cluster 2 (n = 123) was impaired across all domains. Cluster 3 (n = 97) had impaired memory only. Clusters differed in age, race, education, SES, IQ, BMI, and diabetes (ps ≤ .026) but not in mood, anxiety, cardiovascular, or pulmonary disease (ps ≥ .118).

Conclusions

We replicated three distinct patterns of cognitive function in persons with HF. These profiles may help providers offer tailored care to patients with different cognitive and clinical needs.