2.50
Hdl Handle:
http://hdl.handle.net/10755/151222
Type:
Presentation
Title:
Need for Cognitive Screening in Patients with Heart Failure
Abstract:
Need for Cognitive Screening in Patients with Heart Failure
Conference Sponsor:Sigma Theta Tau International
Conference Year:2009
Author:Athilingam, Ponrathi R., PhD, RN, ACNP
P.I. Institution Name:University of Rochester
Title:Assistant Professor Clinical Nursing
[Research Presentation] Purpose:  This research compared the Montreal Cognitive Assessment (MoCA) and the Mini Mental Status Examination (MMSE) regarding their reliability and appropriateness to measure early cognitive changes in patients with heart failure (HF). HF patients have twice the risk of having cognitive deficit (CD) than the general population that may impact adherence to self-care and delay seeking care. Standard of HF care doesn't call for cognitive screening hence, not routinely performed. Methods: A cross sectional study enrolled ninety community dwelling adults aged 50 and above in stable HF. Participants were administered the MMSE and MoCA, questionnaires to measure co-morbidity, depression, disability, and completed a six-minute walk test. Clinical and demographic data were collected via questionnaire. Cerebral perfusion pressure was measured via transcranial doppler and cardiac index via impedance cardiograph. Results:   Most participants were men (66%), Caucasian (78%), aged 50 to 89 (62 +/- 9 years), 80% were in HF stage C, and 77% had ejection fraction <40%. The MoCA identified 54% participants with mild cognitive impairment and 17% with moderate cognitive impairment with a score of (24.86 +/- 2.81) compared to 2.2% on the MMSE with a score of (28.96 +/- 1.66). The results confirm findings of researchers that the MMSE is not sensitive to identify subtle cognitive changes in HF. Also, the MoCA identified pattern of CD in specific neuropsychological domains: delayed recall 87%, Visuo-spatial 69%, memory 61%, and attention 47%; that validates findings of several researchers. Conclusion: The results indicate that MoCA may be a sensitive screening tool in identifying subtle cognitive changes than MMSE. Early identification of CD may help prevent permanent CD and may improve adherence to self-care. An appropriately designed longitudinal study is warranted to validate MoCA, explore use of clinical cut off score <22 on the MoCA, and other factors that may influence CD in HF.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleNeed for Cognitive Screening in Patients with Heart Failureen_GB
dc.identifier.urihttp://hdl.handle.net/10755/151222-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Need for Cognitive Screening in Patients with Heart Failure</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Athilingam, Ponrathi R., PhD, RN, ACNP</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Rochester</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor Clinical Nursing</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">ponrathi_athilingam@urmc.rochester.edu</td></tr><tr><td colspan="2" class="item-abstract">[Research Presentation] Purpose: &nbsp;This research compared the Montreal Cognitive Assessment (MoCA) and the Mini Mental Status Examination (MMSE) regarding their reliability and appropriateness to measure early cognitive changes in patients with heart failure (HF). HF patients have twice the risk of having cognitive deficit (CD) than the general population that may impact adherence to self-care and delay seeking care. Standard of HF care doesn't call for cognitive screening hence, not routinely performed. Methods: A cross sectional study enrolled ninety community dwelling adults aged 50 and above in stable HF. Participants were administered the MMSE and MoCA, questionnaires to measure co-morbidity, depression, disability, and completed a six-minute walk test. Clinical and demographic data were collected via questionnaire. Cerebral perfusion pressure was measured via transcranial doppler and cardiac index via impedance cardiograph. Results: &nbsp; Most participants were men (66%), Caucasian (78%), aged 50 to 89 (62 +/- 9 years), 80% were in HF stage C, and 77% had ejection fraction &lt;40%. The MoCA identified 54% participants with mild cognitive impairment and 17% with moderate cognitive impairment with a score of (24.86 +/- 2.81) compared to 2.2% on the MMSE with a score of (28.96 +/- 1.66). The results confirm findings of researchers that the MMSE is not sensitive to identify subtle cognitive changes in HF. Also, the MoCA identified pattern of CD in specific neuropsychological domains: delayed recall 87%, Visuo-spatial 69%, memory 61%, and attention 47%; that validates findings of several researchers. Conclusion: The results indicate that MoCA may be a sensitive screening tool in identifying subtle cognitive changes than MMSE. Early identification of CD may help prevent permanent CD and may improve adherence to self-care. An appropriately designed longitudinal study is warranted to validate MoCA, explore use of clinical cut off score &lt;22 on the MoCA, and other factors that may influence CD in HF.</td></tr></table>en_GB
dc.date.available2011-10-26T10:55:31Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T10:55:31Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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