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Type: Journal article
Title: Cognitive impairment predicts functional capacity in dementia-free patients with cardiovascular disease
Author: McLennan, S.
Mathias, J.
Brennan, L.
Russell, M.
Stewart, S.
Citation: Journal of Cariovascular Nursing, 2010; 25(5):390-397
Publisher: Lippincott Williams & Wilkins
Issue Date: 2010
ISSN: 0889-4655
Statement of
Skye N. McLennan, Jane L. Mathias, Lucy C. Brennan, Mary E. Russell, Simon Stewart
Abstract: Background and Research Objective: A high proportion of elderly people with cardiovascular diseases and risk factors have mild forms of cognitive impairment, the functional impact of which is poorly understood. The aim of this study was to determine whether subtle cognitive impairment contributes to limitations in instrumental activities of daily living in this group and whether this association is independent of physical comorbidity and other potentially confounding factors. Subjects and Methods: Two hundred and nineteen nondemented patients were recruited from cardiovascular and diabetic hospital outpatient clinics. Functional dependence was assessed using the self-report version of the instrumental activities of daily living scale. Cognitive ability was assessed using the Montreal Cognitive Assessment (MoCA). Demographic and clinical information was collected via interview and a review of hospital records. Standard logistic regression was performed to identify factors independently associated with functional status. Results: Five variables (sex, cardiovascular disease burden, non-cardiovascular disease burden, cognitive status, and age) were independently associated with an increased likelihood of requiring assistance with 1 or more everyday activities. The likelihood of needing assistance increased 2.05 times (95% confidence interval [CI], 1.59-2.79) for each additional cardiovascular diagnosis present and 1.12 times (95% CI, 1.01-1.27) for every point lower on MoCA. Thus, in comparison to a person with a perfect MoCA score, a person who scored in the cognitively impaired range (<23) was 7.7 (CI, 7.07-8.89) times more likely to report that he/she required assistance with an everyday activity. Conclusion: Cognitive impairments appear to reduce the ability to independently carry out routine daily tasks in patients with cardiovascular diseases and risk factors. Cognition should therefore be considered along with physical symptoms when assessing and responding to the support needs of this group.
Keywords: activities of daily living; cardiovascular; cognitive impairment; disability; MoCA
Rights: © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
RMID: 0020102837
DOI: 10.1097/JCN.0b013e3181dae445
Appears in Collections:Psychology publications

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