Abstract 18863: Poorer Attention in Heart Failure is Related to Increased Attentional Demands and Oxygen Saturation

Abstract

Introduction: Attention is critical to performing self-care and is impaired in 25% of patients with heart failure (HF). Although HF patients may have greater attentional demands from their chronic condition, reasons for their impaired attention have included altered oxygenation to the brain, but not mental effort. Purpose: To compare attention between HF patients and age-matched healthy adults and examine relationships between attention and mental effort, blood pressure (BP), and oxygen saturation (SpO2). Methods: Baseline data were included from 40 participants (20 HF, 20 healthy) enrolled in a cognitive intervention study. Attention was measured using 4 neuropsychological tests (Multi-Source Inference Task (MSIT), Stroop, Trail Making (TMT), Digit Span Tests) and perceived attention by Attentional Function Index (AFI). Mental effort for chronic disease was measured by a self-report questionnaire. BP and SpO2 were measured during testing. Descriptive statistics, t-tests, X2 tests, and Pearson correlations were conducted. Significance level was .05. Results: Demographics were similar for HF and healthy groups (age = 60 vs 59 yrs, education = 15 yrs for both). Mean LVEF was 37% and NYHA class was 2.5 in HF patients. Compared with healthy adults, HF patients performed poorer on 3 tests of attention. On TMT, HF patients took 40% longer to complete test A (41 vs 27, p = .001) and B (100 vs 60 sec, p = .002). Similarly, HF patients had slower responses and more errors on MSIT and Stroop test (p = .007 - .045). Patients with HF scored lower in AFI than healthy adults (p < .001). Compared with healthy adults, HF patients had greater mental effort (p = .014), lower BP (110/66 vs 124/74mmHg) and SpO2 (96.6 vs 97.6%). Greater mental effort was related to slower responses on TMT-A and MSIT, more errors on MSIT and Stroop test, and poorer AFI (p = <.001 - .048). Lower SpO2 was related to poorer attention on TMT-B and AFI. More time with SpO2 < 95% was related to poorer attention on TMT-B, MSIT, and AFI. Conclusions: Patients with HF had poorer attention than healthy adults. Poorer attention was associated with increased mental effort and lower oxygen saturation. Future studies are needed to improve attention and to evaluate if improving oxygen and mental effort improve attention in larger samples.