Distinct Factors Associated With Better Self-care in Heart Failure Patients With and Without Mild Cognitive Impairment.

Abstract

A decline in cognition may limit patients' ability to effectively engage in self-care in those with heart failure (HF). However, several studies have shown no difference in self-care between HF patients with and without cognitive impairment. This may indicate that there are more salient factors associated with self-care in HF patients with cognitive impairment compared with those without cognitive impairment. The aim of this study was to explore which factors are related to self-care based on the presence and absence of mild cognitive impairment (MCI) among patients with HF. Patients with HF were recruited from outpatient settings. The Montreal Cognitive Assessment was used to screen for MCI. Self-care was measured with the Self-care of HF Index v.6.2. Two separate stepwise linear regressions were performed to identify which factors (HF knowledge, perceived control, functional status, multimorbidity, executive function, and social support) predicted self-care in HF patients with and without MCI. Of the 132 patients in this study, 36 (27.3%) had MCI. Self-care maintenance and management were associated with social support (β = 0.489) and executive function (β = 0.484), respectively, in patients with MCI. Perceived control was associated with both self-care maintenance and management in patients without MCI (βs = 0.404 and 0.262, respectively). We found that social support and executive function were associated with self-care in HF patients with MCI, whereas perceived control was associated with self-care in HF patients with intact cognition. Clinicians should develop tailored interventions to enhance self-care by considering the distinct factors associated with self-care based on the presence or absence of MCI.