Exercise and Cognitive Training as a Strategy to Improve Neurocognitive Outcomes in Heart Failure: A Pilot Study

Am J Geriatr Psychiatry. 2019 Aug;27(8):809-819. doi: 10.1016/j.jagp.2019.01.211. Epub 2019 Feb 1.


Objective: Mild cognitive impairment, especially memory loss, is prevalent in patients with heart failure (HF) and contributes to poor clinical outcomes and higher mortality.

Methods: This study evaluated a combined aerobic exercise and cognitive training (EX/CT) program on memory, executive function, attention, processing speed and reaction time compared to exercise only or a usual care attention control (UCAC) stretching and flexibility program. Participants completed a standardized neurocognitive battery at baseline, 3 months, and 6 months along with demographic, clinical, and functional capacity (6-minute walk test). A linear mixed model analysis was used with comorbidity as a covariate.

Results: Sixty-nine participants were enrolled, the mean age was 61 ± 10 years, 54% were women, 55% were African American, and the mean left ventricular ejection fraction percentage was 35 ± 15. A significant group by time interaction for verbal memory was found at 3 months (F [2, 53] = 4.3, p = 0.018) but was not sustained at 6 months in the EX/CT group. Processing speed/attention differed across treatment groups between baseline and 6 months, but improvement occurred among UCAC participants. There were also significant group differences in the 6MWT distance occurring at 3 months (F [2, 52] = 3.5, p = 0.036); however, significant improvement was observed within the EX/CT group only. There were no significant differences in 6MWT in the other groups at 3 or 6 months.

Conclusion: An EX/CT intervention was associated with improved memory in persons with HF and warrants further investigation in a larger trial. The relationship between functional capacity and cognitive function also needs further study.

Trial registration: ClinicalTrials.gov NCT02151266.

Keywords: Heart failure; cognitive training; exercise; mild cognitive impairment.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Attention / physiology
  • Cognitive Dysfunction / etiology
  • Cognitive Dysfunction / physiopathology
  • Cognitive Dysfunction / therapy*
  • Cognitive Remediation*
  • Combined Modality Therapy
  • Executive Function / physiology
  • Exercise Therapy*
  • Female
  • Follow-Up Studies
  • Heart Failure / complications*
  • Heart Failure / physiopathology
  • Humans
  • Male
  • Memory Disorders / etiology
  • Memory Disorders / physiopathology
  • Memory Disorders / therapy*
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Pilot Projects
  • Psychomotor Performance / physiology
  • Reaction Time / physiology
  • Severity of Illness Index
  • Verbal Learning / physiology

Associated data

  • ClinicalTrials.gov/NCT02151266