Alosco Michael L, Spitznagel Mary Beth, Raz Naftali, Cohen Ronald, Sweet Lawrence H, Colbert Lisa H, Josephson Richard, van Dulmen Manfred, Hughes Joel, Rosneck Jim, Gunstad John
Department of Psychology, Kent State University, Kent, OH, USA.
J Clin Nurs. 2014 Mar;23(5-6):829-36. doi: 10.1111/jocn.12214. Epub 2013 May 8.
To examine the independent association between executive function with instrumental activities of daily living and health behaviours in older adults with heart failure.
Executive function is an important contributor to functional independence as it consists of cognitive processes needed for decision-making, planning, organising and behavioural monitoring. Impairment in this domain is common in heart failure patients and associated with reduced performance of instrumental activities of daily living in many medical and neurological populations. However, the contribution of executive functions to functional independence and healthy lifestyle choices in heart failure patients has not been fully examined.
Cross-sectional analyses.
One hundred and seventy-five heart failure patients completed a neuropsychological battery and echocardiogram. Participants also completed the Lawton-Brody Instrumental Activities of Daily Living Scale and reported current cigarette use.
Hierarchical regressions revealed that reduced executive function was independently associated with worse instrumental activity of daily living performance with a specific association for decreased ability to manage medications. Partial correlations showed that executive dysfunction was associated with current cigarette use.
Our findings suggest that executive dysfunction is associated with poorer functional independence and contributes to unhealthy behaviours in heart failure. Future studies should examine whether heart failure patients benefit from formal organisation schema (i.e. pill organisers) to maintain independence.
Screening of executive function in heart failure patients may provide key insight into their ability to perform daily tasks, including the management of treatment recommendations.
探讨心力衰竭老年患者执行功能与日常生活工具性活动及健康行为之间的独立关联。
执行功能是功能独立性的重要因素，因为它由决策、规划、组织和行为监测所需的认知过程组成。这一领域的损害在心力衰竭患者中很常见，并且在许多医学和神经学人群中与日常生活工具性活动表现降低有关。然而，执行功能对心力衰竭患者功能独立性和健康生活方式选择的贡献尚未得到充分研究。
横断面分析。
175名心力衰竭患者完成了一套神经心理学测试和超声心动图检查。参与者还完成了洛顿-布罗迪日常生活工具性活动量表，并报告了当前的吸烟情况。
分层回归显示，执行功能降低与日常生活工具性活动表现较差独立相关，尤其是在药物管理能力下降方面存在特定关联。偏相关性分析表明，执行功能障碍与当前吸烟情况有关。
我们的研究结果表明，执行功能障碍与功能独立性较差相关，并导致心力衰竭患者出现不健康行为。未来的研究应探讨心力衰竭患者是否能从正式的组织方案（如药盒）中受益以维持独立性。
对心力衰竭患者进行执行功能筛查可能有助于深入了解他们执行日常任务的能力，包括治疗建议的管理。
