Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation
Annett Salzwedel,1 Maria-Dorothea Heidler,1,2 Kathrin Haubold,1 Martin Schikora,2 Rona Reibis,3 Karl Wegscheider,4 Michael Jöbges,2 Heinz Völler1,5 1Center for Rehabilitation Research, University of Potsdam, Potsdam, 2Brandenburg Klinik, Bernau, 3Cardiological Outpatient Clinic, Am...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2017-02-01
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| Series: | Vascular Health and Risk Management |
| Subjects: | |
| Online Access: | https://www.dovepress.com/prevalence-of-mild-cognitive-impairment-in-employable-patients-after-a-peer-reviewed-article-VHRM |
| _version_ | 1818941584237920256 |
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| author | Salzwedel A Heidler MD Haubold K Schikora M Reibis R Wegscheider K Jöbges M Völler H |
| author_facet | Salzwedel A Heidler MD Haubold K Schikora M Reibis R Wegscheider K Jöbges M Völler H |
| author_sort | Salzwedel A |
| collection | DOAJ |
| description | Annett Salzwedel,1 Maria-Dorothea Heidler,1,2 Kathrin Haubold,1 Martin Schikora,2 Rona Reibis,3 Karl Wegscheider,4 Michael Jöbges,2 Heinz Völler1,5 1Center for Rehabilitation Research, University of Potsdam, Potsdam, 2Brandenburg Klinik, Bernau, 3Cardiological Outpatient Clinic, Am Park Sanssouci, Potsdam, 4Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, 5Klinik am See, Rüdersdorf, Germany Introduction: Adequate cognitive function in patients is a prerequisite for successful implementation of patient education and lifestyle coping in comprehensive cardiac rehabilitation (CR) programs. Although the association between cardiovascular diseases and cognitive impairments (CIs) is well known, the prevalence particularly of mild CI in CR and the characteristics of affected patients have been insufficiently investigated so far. Methods: In this prospective observational study, 496 patients (54.5 ± 6.2 years, 79.8% men) with coronary artery disease following an acute coronary event (ACE) were analyzed. Patients were enrolled within 14 days of discharge from the hospital in a 3-week inpatient CR program. Patients were tested for CI using the Montreal Cognitive Assessment (MoCA) upon admission to and discharge from CR. Additionally, sociodemographic, clinical, and physiological variables were documented. The data were analyzed descriptively and in a multivariate stepwise backward elimination regression model with respect to CI. Results: At admission to CR, the CI (MoCA score < 26) was determined in 182 patients (36.7%). Significant differences between CI and no CI groups were identified, and CI group was associated with high prevalence of smoking (65.9 vs 56.7%, P = 0.046), heavy (physically demanding) workloads (26.4 vs 17.8%, P < 0.001), sick leave longer than 1 month prior to CR (28.6 vs 18.5%, P = 0.026), reduced exercise capacity (102.5 vs 118.8 W, P = 0.006), and a shorter 6-min walking distance (401.7 vs 421.3 m, P = 0.021) compared to no CI group. The age- and education-adjusted model showed positive associations with CI only for sick leave more than 1 month prior to ACE (odds ratio [OR] 1.673, 95% confidence interval 1.07–2.79; P = 0.03) and heavy workloads (OR 2.18, 95% confidence interval 1.42–3.36; P < 0.01). Conclusion: The prevalence of CI in CR was considerably high, affecting more than one-third of cardiac patients. Besides age and education level, CI was associated with heavy workloads and a longer sick leave before ACE. Keywords: cardiac rehabilitation, cognitive impairment, prevalence, acute coronary event, patient education |
| first_indexed | 2024-12-20T06:57:51Z |
| format | Article |
| id | doaj.art-7c926fa90f4a494f988a4f470cff0813 |
| institution | Directory Open Access Journal |
| issn | 1178-2048 |
| language | English |
| last_indexed | 2024-12-20T06:57:51Z |
| publishDate | 2017-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Vascular Health and Risk Management |
| spelling | doaj.art-7c926fa90f4a494f988a4f470cff08132022-12-21T19:49:17ZengDove Medical PressVascular Health and Risk Management1178-20482017-02-01Volume 13556031540Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitationSalzwedel AHeidler MDHaubold KSchikora MReibis RWegscheider KJöbges MVöller HAnnett Salzwedel,1 Maria-Dorothea Heidler,1,2 Kathrin Haubold,1 Martin Schikora,2 Rona Reibis,3 Karl Wegscheider,4 Michael Jöbges,2 Heinz Völler1,5 1Center for Rehabilitation Research, University of Potsdam, Potsdam, 2Brandenburg Klinik, Bernau, 3Cardiological Outpatient Clinic, Am Park Sanssouci, Potsdam, 4Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, 5Klinik am See, Rüdersdorf, Germany Introduction: Adequate cognitive function in patients is a prerequisite for successful implementation of patient education and lifestyle coping in comprehensive cardiac rehabilitation (CR) programs. Although the association between cardiovascular diseases and cognitive impairments (CIs) is well known, the prevalence particularly of mild CI in CR and the characteristics of affected patients have been insufficiently investigated so far. Methods: In this prospective observational study, 496 patients (54.5 ± 6.2 years, 79.8% men) with coronary artery disease following an acute coronary event (ACE) were analyzed. Patients were enrolled within 14 days of discharge from the hospital in a 3-week inpatient CR program. Patients were tested for CI using the Montreal Cognitive Assessment (MoCA) upon admission to and discharge from CR. Additionally, sociodemographic, clinical, and physiological variables were documented. The data were analyzed descriptively and in a multivariate stepwise backward elimination regression model with respect to CI. Results: At admission to CR, the CI (MoCA score < 26) was determined in 182 patients (36.7%). Significant differences between CI and no CI groups were identified, and CI group was associated with high prevalence of smoking (65.9 vs 56.7%, P = 0.046), heavy (physically demanding) workloads (26.4 vs 17.8%, P < 0.001), sick leave longer than 1 month prior to CR (28.6 vs 18.5%, P = 0.026), reduced exercise capacity (102.5 vs 118.8 W, P = 0.006), and a shorter 6-min walking distance (401.7 vs 421.3 m, P = 0.021) compared to no CI group. The age- and education-adjusted model showed positive associations with CI only for sick leave more than 1 month prior to ACE (odds ratio [OR] 1.673, 95% confidence interval 1.07–2.79; P = 0.03) and heavy workloads (OR 2.18, 95% confidence interval 1.42–3.36; P < 0.01). Conclusion: The prevalence of CI in CR was considerably high, affecting more than one-third of cardiac patients. Besides age and education level, CI was associated with heavy workloads and a longer sick leave before ACE. Keywords: cardiac rehabilitation, cognitive impairment, prevalence, acute coronary event, patient educationhttps://www.dovepress.com/prevalence-of-mild-cognitive-impairment-in-employable-patients-after-a-peer-reviewed-article-VHRMcardiac rehabilitationmild cognitive impairmentprevalenceacute coronary syndrome |
| spellingShingle | Salzwedel A Heidler MD Haubold K Schikora M Reibis R Wegscheider K Jöbges M Völler H Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation Vascular Health and Risk Management cardiac rehabilitation mild cognitive impairment prevalence acute coronary syndrome |
| title | Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation |
| title_full | Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation |
| title_fullStr | Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation |
| title_full_unstemmed | Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation |
| title_short | Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation |
| title_sort | prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation |
| topic | cardiac rehabilitation mild cognitive impairment prevalence acute coronary syndrome |
| url | https://www.dovepress.com/prevalence-of-mild-cognitive-impairment-in-employable-patients-after-a-peer-reviewed-article-VHRM |
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