Clinical Utility of Auditory Memory Testing in a Heart Failure Population

Dustin B. Hammers, PhD Assistant Professor, Center for Alzheimer's Care, Imaging, and Research, Department of Neurology, University of Utah, Salt Lake City. Miyeon Jung, MSN, RN Graduate Student, School of Nursing, University of Michigan, Ann Arbor. Susan Pressler, PhD, RN Professor and Associate Dean of Graduate Studies, School of Nursing, University of Michigan, Ann Arbor. Barbara-Jean Sullivan, PhD, NP Clinical Assistant Professor, School of Nursing, University of Michigan, and Anxiety Disorders Section, Department of Psychiatry, University of Michigan Depression Center, Ann Arbor. Todd Koelling, MD Associate Professor, Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor. Bruno Giordani, PhD Associate Professor, Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor.
The Journal of cardiovascular nursing (Impact Factor: 2.05). 06/2012; 28(5). DOI: 10.1097/JCN.0b013e318258abf3
Source: PubMed


BACKGROUND:: The self-care regimen necessary in heart failure (HF) is notably complex. A complication to integrating new knowledge and behaviors is that impaired cognition has been frequently reported in patients with HF, which significantly impacts patients' health, admission and mortality rates, and instrumental activities of daily living. OBJECTIVE:: The identification of reliable cognitive screening tools to assess potential difficulties in performing self-care for cardiac populations is essential. As such, the current purposes were to evaluate the validity and stability of the International Shopping List (ISL) auditory learning subtest from the computerized CogState battery as a screening tool in HF populations, determine the ISL's ability to predict functional declines, and evaluate the task's sensitivity in myocardial infarction. METHODS:: Forty patients with chronic HF were enrolled in a longitudinal study evaluating the impact of a cognitive training intervention. Baseline neuropsychological and behavioral measurements before treatment were used in the current study, including measures of auditory memory, orientation, verbal fluency, processing speed, and activities of daily living, and a subset of patients (n = 17) received repeat testing at 8 weeks on some tasks. Analyses also were performed with patients organized based on myocardial infarction status. RESULTS:: The current study indicated that the ISL performed comparably with an established measure of auditory memory (Hopkins Verbal Learning Test-Revised; r = 0.70, P < .001), displayed adequate coefficients of stability (r = 0.53-0.68), and successfully predicted declines over time in daily functioning (β = .47, P < .001) in our HF sample. CONCLUSIONS:: The computerized CogState auditory memory subtest, the ISL, seems to be a beneficial tool in evaluating cognitive change in HF patients. Particularly given its cross-cultural sensitivity and ease of administration and scoring, this task may provide assistance to quickly and reliably monitor memory functioning in these vulnerable patients and gauge their potential for self-care behaviors.

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