Abstract 15330: Association of Cognition With Self-Care and With Health-Related Quality of Life in Heart Failure: Does Gender Moderate the Associations?

Abstract

Introduction: The associations of cognition with self-care of heart failure (HF) or with health-related quality of life (HRQL) have not been definitively established, Gender may moderate these associations. The aim of our study was to examine the associations between cognition and (1) HF self-care and (2) HRQL and explore (3) gender as a moderator. Methods: Baseline data were analyzed from a randomized trial of a cognitive intervention (N=73). A neuropsychological battery was used to assess cognition (i.e., global cognition, memory, attention, executive function, language). Self-Care of Heart Failure Index and Minnesota Living with Heart Failure were used to assess self-care (i.e., maintenance, management, perception, confidence) and HRQL, respectively. Moderated multiple regressions were performed using Hayes’ PROCESS macro v4.1 with cognition as the independent variable, gender as the moderator, and HF self-care or HRQL as dependent variables in separate models. Covariates were age and education. Results: Participants’ characteristics were: mean age=66±12 years; mean education=14±2 years; 56% women; mean LVEF=50±14%. Average scores were: self-care maintenance=68±12, management=64±16, perception=74±16, confidence=78±13, HRQL=29±22. Better attention scores were significantly associated with better self-care confidence (b=-1.002, p=.022). Gender moderated the relationships between attention and self-care perception (p=.030). Better attention was associated with better self-care perception among women but with worse self-care perception among men. Gender moderated the relationships between memory and HRQL (p=.050) as well as executive function and HRQL (p=.041). Women’s HRQL did not differ by memory or executive function, but men with better memory or executive function had better HRQL. Conclusion: Better attention was associated with better self-care confidence in HF. Associations between attention and self-care perception, memory and HRQL, and executive function and HRQL differed by gender. Interventions are needed to improve attention, memory, and executive function that may improve HF self-care and HRQL. The effects of gender need to be considered when designing future interventions.