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Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation

  • Introduction: Adequate cognitive function in patients is a prerequisite for successful implementation of patient education and lifestyle coping in comprehensive cardiac rehabilitation (CR) programs. Although the association between cardiovascular diseases and cognitive impairments (CIs) is well known, the prevalence particularly of mild CI in CR and the characteristics of affected patients have been insufficiently investigated so far. Methods: In this prospective observational study, 496 patients (54.5 ± 6.2 years, 79.8% men) with coronary artery disease following an acute coronary event (ACE) were analyzed. Patients were enrolled within 14 days of discharge from the hospital in a 3-week inpatient CR program. Patients were tested for CI using the Montreal Cognitive Assessment (MoCA) upon admission to and discharge from CR. Additionally, sociodemographic, clinical, and physiological variables were documented. The data were analyzed descriptively and in a multivariate stepwise backward elimination regression model with respect to CI.Introduction: Adequate cognitive function in patients is a prerequisite for successful implementation of patient education and lifestyle coping in comprehensive cardiac rehabilitation (CR) programs. Although the association between cardiovascular diseases and cognitive impairments (CIs) is well known, the prevalence particularly of mild CI in CR and the characteristics of affected patients have been insufficiently investigated so far. Methods: In this prospective observational study, 496 patients (54.5 ± 6.2 years, 79.8% men) with coronary artery disease following an acute coronary event (ACE) were analyzed. Patients were enrolled within 14 days of discharge from the hospital in a 3-week inpatient CR program. Patients were tested for CI using the Montreal Cognitive Assessment (MoCA) upon admission to and discharge from CR. Additionally, sociodemographic, clinical, and physiological variables were documented. The data were analyzed descriptively and in a multivariate stepwise backward elimination regression model with respect to CI. Results: At admission to CR, the CI (MoCA score < 26) was determined in 182 patients (36.7%). Significant differences between CI and no CI groups were identified, and CI group was associated with high prevalence of smoking (65.9 vs 56.7%, P = 0.046), heavy (physically demanding) workloads (26.4 vs 17.8%, P < 0.001), sick leave longer than 1 month prior to CR (28.6 vs 18.5%, P = 0.026), reduced exercise capacity (102.5 vs 118.8 W, P = 0.006), and a shorter 6-min walking distance (401.7 vs 421.3 m, P = 0.021) compared to no CI group. The age- and education-adjusted model showed positive associations with CI only for sick leave more than 1 month prior to ACE (odds ratio [OR] 1.673, 95% confidence interval 1.07–2.79; P = 0.03) and heavy workloads (OR 2.18, 95% confidence interval 1.42–3.36; P < 0.01). Conclusion: The prevalence of CI in CR was considerably high, affecting more than one-third of cardiac patients. Besides age and education level, CI was associated with heavy workloads and a longer sick leave before ACE.show moreshow less

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Author details:Annett SalzwedelORCiDGND, Maria-Dorothea HeidlerORCiDGND, Kathrin HauboldORCiDGND, Martin Schikora, Rona Katharina ReibisORCiDGND, Karl WegscheiderORCiDGND, Michael Jöbgens, Heinz VöllerORCiDGND
URN:urn:nbn:de:kobv:517-opus4-104113
Publication series (Volume number):Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe (314)
Publication type:Postprint
Language:English
Date of first publication:2017/02/23
Publication year:2016
Publishing institution:Universität Potsdam
Release date:2017/03/03
Tag:acute coronary event; cardiac rehabilitation; cognitive impairment; patient education; prevalence
Number of pages:6
First page:55
Last Page:60
Source:Vascular Health and Risk Management (2017) Nr. 13, S. 55-60. - DOI: 10.2147/VHRM.S121086
Funding institution:Universität Potsdam, Publikationsfonds
Funding number:PA 2017_02
Organizational units:Humanwissenschaftliche Fakultät / Strukturbereich Kognitionswissenschaften / Department Sport- und Gesundheitswissenschaften
DDC classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Peer review:Referiert
License (English):License LogoCreative Commons - Namensnennung-Nicht kommerziell 3.0 Unported
External remark:Bibliographieeintrag der Originalveröffentlichung/Quelle
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