Abstract
Background
Heart failure (HF) and obesity are associated with cognitive impairment. However,
few studies have investigated the relationship between adiposity and cognitive functioning
in HF for each sex, despite observed sex differences in HF prognosis. We tested the
hypothesis that greater body mass index (BMI) would be associated with poorer cognitive
functioning, especially in men, in sex-stratified analyses.
Methods and Results
Participants were 231 HF patients (34% female, 24% nonwhite, average age 68.7 ± 7.3
years). Height and weight were used to compute BMI. A neuropsychology battery tested
global cognitive function, memory, attention, and executive function. Composites were
created using averages of age-adjusted scaled scores. Regressions adjusting for demographic
and medical factors were conducted. The sample was predominantly overweight/obese
(76.2%). For men, greater BMI predicted poorer attention (ΔR2 = 0.03; β = −0.18; P = .01) and executive function (ΔR2 = 0.02; β = −0.13; P = .04); these effects were largely driven by men with severe obesity (BMI ≥40 kg/m2). BMI did not predict memory (P = .69) or global cognitive functioning (P = .08). In women, greater BMI was not associated with any cognitive variable (all
P ≥ .09).
Discussion
Higher BMI was associated with poorer attention and executive function in male HF
patients, especially those with severe obesity. These patients may therefore have
more difficulties with the HF treatment regimen and may have poorer outcomes.
Key Words
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Article info
Publication history
Published online: December 23, 2013
Accepted:
December 16,
2013
Received in revised form:
November 20,
2013
Received:
September 5,
2013
Footnotes
Funding: NHLBI, 1 R01 HL096710-01A1 to Drs Hughes and Dolansky.
See page 205 for disclosure information.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
