Table 1 Study and Population Characteristics
From: Self-management of heart failure in dementia and cognitive impairment: a systematic review
Author | Country | Aim | Study Duration (months) | Data Type | Study Design | Method(s) of data collection | Setting | Population setting | Population size (n) | Age mean and range | Female (n and/or %) | HF severity (n and/or %) | Cognitive impairment test(s) and cutoff scores | Cognitive Impairment (n and/or %) | Comorbidities (n and/or %)* | Quality Assessment |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Alosco, 2012 | USA | To examine whether cognitive functioning is associated with poorer Adh to treatment recommendations | – | Cross Sectional | Obs | Ques, Exam | Primary Care/Cardiology Practice | Urban | 149 | 68.1 (SD = 10.7) | 37% | NYHA II/III LVEF: 41.0 (SD = 14.8) | – | – | Diabetes: 34% Depression: 22% Hypertension: 72% Myocardial Infarct: 52% | Fair |
Alosco, 2012 | USA | To examine whether cognitive functioning is able to predict ADL performance | – | Cross Sectional | Obs | Ques, Exam | Primary Care/Cardiology Practice | Urban | 122 | 68.5 (SD = 9.4) | 35% | NYHA II/III | MMSE | – | Diabetes: 33% Hypertension: 66% Myocardial Infarct: 54% | Fair |
Alosco, 2014 | USA | To examine the association between EF and IADL in HF patients & to examine the association between executive dysfunction and unhealthy lifestyle behaviors. | – | Cross Sectional | Obs | Ques, Exam | – | Urban | 179 | 68.1 (SD = 10.3) | 36% | NYHA II/III/IV LVEF: 41.0 (SD = 15.1) | – | – | Diabetes: 37% Hypertension: 70% | Fair |
Cameron, 2009 | AUS | To test a conceptual model of factors drawn from the literature as determinants of chronic HF SC | – | Cross Sectional | Obs | Int | Inpatient | Urban | 50 | 73 (SD = 11) | 12 (24%) | NYHA III/IV: 25 (50%) | MMSE (< 27) | 18 (36%) | Mild/Moderate: 32 (64%) Severe: 18 (36%) | Good |
Dickson, 2008 | USA | To explore how attitudes, self-efficacy and cognition influence the decision making processes underlying HF SC. | – | Cross Sectional | Obs | Int | Outpatient | Urban | 41 | 49.2 (SD = 10.5) Range: 25–65 | 15 (37%) | NYHA II/III Mean ejection fraction: 34% | – | – | Mild: 17 (41%) Moderate: 20 (49%) Severe: 4 (10%) | Fair |
Habota, 2015 | AUS | To compare prospective memory ability of CHF patients and matched controls | 3 | Cross Sectional | Obs | Int | Outpatient | Urban | 30 | 70.0 (SD = 11.9) Range: 40–86 | 37% | NYHA III/IV: (30%) | ACE-R | – | Diabetes: 5 (17%) Hypertension: 20 (67%) | Fair |
Harkness, 2014 | CAN | To determine if MCI was significantly associated with SC management in a community dwelling sample of older HF patients | – | Cross Sectional | Obs | Ques, Exam | Outpatient | Urban | 100 | 72.4 (SD = 9.8) | 32% | NYHA III: 43 (43%) LVEF≤45: 90% | MoCA (< 26, < 24 – CVS cutoff) | < 26: 73% < 24: 56% | AF: 54 (54%) Diabetes: 43 (43%) Depression: 12 (12%) Hypertension: 73 (73%) | Good |
Hawkins, 2012 | USA | To describe the prevalence and severity of CI in an OP veteran population with HF and to describe the cognitive domains affected. To examine the clinical and demographic variables associated with CI and to determine the relationship between CI and MA | – | Prospective | Coh | Int, Exam | Outpatient/General Medical Clinic | Urban | 251 | 66 (SD = 9.8) Range: 33–93 | 4 (1.6%) | LVEF: 37.5 (SD = 16.9) | SLUMS (< 27 with HSQ, < 25 with-out) | 144 (58%)‡ | AF: 82 (32.7%) Diabetes: 134 (53.4%) Depression: 76 (30.3%)‡ Hypertension: 193 (76.9%) | Good |
Hjelm, 2015 | SWE | To a) test the association between cognitive function and SC in HF patients, b) explore which cognitive areas were affected, c) determine if DP moderated the association between cognitive function and SC. | – | Cross Sectional | Obs | Ques, Exam | Outpatient | Urban | 142 | Median: 72, Range: 65–79 | 45 (32%) | NYHA III/IV: 55 (39%) LVEF< 40: 102 (72%) | MMSE | – | Mild: 116 (82%) Moderate: 22 (15%) Severe: 3 (2%) | Good |
Karlsson, 2005 | SWE | To assess the effect of a nurse based management program to increase HF patients’ knowledge about disease and SC. To compare these results to gender and cognitive function | 6 | Prospective | RCT | Ques, Int | Outpatient | Urban | Interv: 72 Control: 74 | 76, SD = 8 vs. 76 SD = 7§ | 31 (43%) vs. 33 (45%)§ | NYHA III/IV: 31 (43%) vs. 22 (30%)§ LVEF: 33 (SD = 12) vs. 35 (SD = 10)§ | MMSE | – | Diabetes: 17 (24%) vs. 15 (20%)§ Hypertension: 30 (42%) vs. 21 (28%)§|| | Fair |
Kim, 2015 | KOR | To examine a) global cognition, M and EF, b) differences in these domains when comparing asymptomatic and symptomatic HF c) the association between cognitive function and SC Adh in HF patients d) the influence of the cognitive domains on MACE | 24 | Prospective | Coh | Int | Outpatient | Urban | 86 | 58.3 (SD = 12.9) | 28 (34%) | NYHA III/IV: 8 (9%) LVEF: 51 (SD = 15) | K-MMSE (< 23.5) | 28 (33%) | AF: 15 (17%) Diabetes: 13 (15%) | Fair |
Lee, 2013 | USA | To quantify the relationship between MCI and, SC and consulting behaviours | – | Cross Sectional | Obs | Ques, Exam | Outpatient | Urban | 148 | 56.9 (SD = 12.4) | 57 (39%) | NYHA III/IV: 87 (59%) LVEF: 28 (SD = 12) | MoCA (< 26, < 24 – CVS cutoff) | < 26: 49 (33%) < 24: 21 (14%) | Mild: 95 (64%) Moderate: 44 (30%) Severe: 9 (6%) | Good |
Smeulders, 2010 | NED | To identify the characteristics of CHF patients that benefitted most from the CDSMP | 27 | Prospective | RCT | Ques, Int (T) | Outpatient | Urban | Interv: 186 Control: 131 | 66.7 (SD = 10.6), 66.6 (SD = 11.0) vs. 66.8 (SD = 10.1)§ | 45 (24.2%) vs. 42 (32.1%)§ | NYHA III: 66 (36%) vs. 40 (31%)§ | TICS (< 33.0) | 99 (53.2%) vs. 78 (59.5%)§ | – | Fair |
Vellone, 2015 | ITA | To determine whether SC confidence mediates the relationship between cognition and SC behaviours | – | Cross Sectional | Obs | Int | Outpatient | Urban | 628 | 73.0 (SD = 11.3) | 266 (42.6%) | NYHA III/IV: 340 (54.1%) LVEF: 43.1 (SD = 11.6) | MMSE | – | – | Fair |