Cognitive Function and Self-Care Management in Older Patients With Heart Failure

Eur J Cardiovasc Nurs. 2014 Jun;13(3):277-84. doi: 10.1177/1474515113492603. Epub 2013 Jun 3.


Aims: People with heart failure have difficulty with self-care management. We do not know if patients with heart failure have difficulty with self-care management due to underlying, mild cognitive impairment (MCI). The purpose of this study was to determine whether MCI, as identified on a simple screening tool, is significantly associated with self-care management in a sample of community dwelling older patients with heart failure.

Methods and results: Using a cross-sectional design, heart failure patients (n=100, mean age 72 SD 10 years) attending an outpatient heart failure clinic completed the Montreal Cognitive Assessment tool (MoCA), Self-Care in Heart Failure Index (SCHFI) and Geriatric Depression Scale. The presence of MCI, as defined by a MoCA score <26, was present in 73% patients; 21% had an adequate self-care management SCHFI score; and 12% reported symptoms of depression. Participants with a MoCA score <26 vs. ≥ 26 scored significantly lower on the self-care management subscale of the SCHFI (48.1 SD 24 vs. 59.3 SD 22 respectively, p=0.035). Using backward regression, the final model was fitted to self-care management while controlling for age and sex and was significant, with (F= 7.04 df (3, 96), and p<0.001), accounting for 18% of the total variance in self-care management (R (2) = 18.03%). The MoCA score was the only variable which remained in the model significantly with p= 0.001.

Conclusion: Findings from this study highlight the difficulty older heart failure patients have with self-care management and the need to include formal screening for MCI when exploring variables contributing to self-care management in heart failure patients.

Keywords: Self-care management; cognitive function; heart failure.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cognition
  • Cognitive Dysfunction / complications*
  • Cognitive Dysfunction / diagnosis
  • Communication Barriers
  • Cross-Sectional Studies
  • Female
  • Heart Failure* / complications
  • Heart Failure* / psychology
  • Heart Failure* / therapy
  • Humans
  • Male
  • Mass Screening / methods
  • Middle Aged
  • Neuropsychological Tests
  • Patient Care Team
  • Residence Characteristics
  • Self Care / methods*
  • Self Care / psychology*
  • Stress, Psychological / diagnosis
  • Stress, Psychological / psychology