Browsing by Author "Dorsey, Susan G."

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    Design and Rationale of the Cognitive Intervention to Improve Memory in Heart Failure Patients Study
    (Wolters Kluwer, 2018-07) Pressler, Susan J.; Giordani, Bruno; Titler, Marita; Gradus-Pizlo, Irmina; Smith, Dean; Dorsey, Susan G.; Gao, Sujuan; Jung, Miyeon; School of Nursing
    BACKGROUND: Memory loss is an independent predictor of mortality among heart failure patients. Twenty-three percent to 50% of heart failure patients have comorbid memory loss, but few interventions are available to treat the memory loss. The aims of this 3-arm randomized controlled trial were to (1) evaluate efficacy of computerized cognitive training intervention using BrainHQ to improve primary outcomes of memory and serum brain-derived neurotrophic factor levels and secondary outcomes of working memory, instrumental activities of daily living, and health-related quality of life among heart failure patients; (2) evaluate incremental cost-effectiveness of BrainHQ; and (3) examine depressive symptoms and genomic moderators of BrainHQ effect. METHODS: A sample of 264 heart failure patients within 4 equal-sized blocks (normal/low baseline cognitive function and gender) will be randomly assigned to (1) BrainHQ, (2) active control computer-based crossword puzzles, and (3) usual care control groups. BrainHQ is an 8-week, 40-hour program individualized to each patient's performance. Data collection will be completed at baseline and at 10 weeks and 4 and 8 months. Descriptive statistics, mixed model analyses, and cost-utility analysis using intent-to-treat approach will be computed. CONCLUSIONS: This research will provide new knowledge about the efficacy of BrainHQ to improve memory and increase serum brain-derived neurotrophic factor levels in heart failure. If efficacious, the intervention will provide a new therapeutic approach that is easy to disseminate to treat a serious comorbid condition of heart failure.
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    Evaluating Depressive Symptoms, BDNF Val66Met, and APOE-ε4 as Moderators of Response to Computerized Cognitive Training in Heart Failure
    (Elsevier, 2023) Pressler, Susan J.; Jung, Miyeon; Giordani, Bruno; Titler, Marita G.; Gradus-Pizlo, Irmina; Reid Lake, Kittie; Wierenga, Kelly L.; Clark, David G.; Perkins, Susan M.; Smith, Dean G.; Mocci, Evelina; Dorsey, Susan G.; School of Nursing
    Background: Depressive symptoms, brain-derived neurotrophic factor (BDNF) Val66Met, and apolipoprotein (APOE)-ε4 may moderate response to computerized cognitive training (CCT) interventions among patients with heart failure (HF). Objectives: The purpose of this study was to examine moderators of intervention response to CCT over 8 months among patients with HF enrolled in a 3-arm randomized controlled trial. Outcomes were memory, serum BDNF, working memory, instrumental activities of daily living (IADLs), and health-related quality of life (HRQL). Methods: 256 patients with HF were randomized to CCT, computerized crossword puzzles active control, and usual care control groups for 8 weeks. Data were collected at enrollment, baseline, 10 weeks, and 4 and 8 months. Mixed effects models were computed to evaluate moderators. Results: As previously reported, there were no statistically significant group by time effects in outcomes among the 3 groups over 8 months. Tests of moderation indicated that depressive symptoms and presence of BDNF Val66Met and APOE-ε4 were not statistically significant moderators of intervention response in outcomes of delayed recall memory, serum BDNF, working memory, IADLs, and HRQL. In post hoc analysis evaluating baseline global cognitive function, gender, age, and HF severity as moderators, no significant effects were found. HF severity was imbalanced among groups (P = .049) which may have influenced results. Conclusions: Studies are needed to elucidate biological mechanisms of cognitive dysfunction in HF and test novel interventions to improve memory, serum BDNF, working memory, IADLs and HRQL. Patients may need to be stratified or randomized by HF severity within intervention trials.
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    Randomized Controlled Trial of a Cognitive Intervention to Improve Memory in Heart Failure
    (Elsevier, 2022) Pressler, Susan J.; Jung, Miyeon; Gradus-Pizlo, Irmina; Titler, Marita G.; Smith, Dean G.; Gao, Sujuan; Lake, Kittie Reid; Burney, Heather; Clark, David G.; Wierenga, Kelly L.; Dorsey, Susan G.; Giordani, Bruno; School of Nursing
    Background: The objective of this 3-arm randomized controlled trial was to evaluate the efficacy of computerized cognitive training (CCT) in improving primary outcomes of delayed-recall memory and serum brain-derived neurotrophic factor (BDNF) levels; and the secondary outcomes were working memory, instrumental activities of daily living (IADLs) and health-related quality of life (HRQL) in patients with heart failure (HF). Methods and results: Patients (n = 256) were randomly assigned to 8 weeks of CCT using BrainHQ, computerized crossword puzzles active control intervention, and usual care. All patients received weekly nurse-enhancement interventions. Data were collected at enrollment and baseline visits and at 10 weeks and 4 and 8 months. In mixed effects models, there were no statistically significant group or group-by-time differences in outcomes. There were statistically significant differences over time in all outcomes in all groups. Patients improved over time on measures of delayed-recall memory, working memory, IADLs, and HRQL and had decreased serum BDNF. Conclusions: CCT did not improve outcomes compared with the active control intervention and usual care. Nurse-enhancement interventions may have led to improved outcomes over time. Future studies are needed to test nurse-enhancement interventions in combination with other cognitive interventions to improve memory in persons with HF.
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    The National Cancer Institute clinical trials planning meeting to address gaps in observational and intervention trials for cancer-related cognitive impairment
    (Oxford University Press, 2025) Janelsins, Michelle C.; Van Dyk, Kathleen; Hartman, Sheri J.; Koll, Thuy T.; Cramer, Christina K.; Lesser, Glenn J.; Barton, Debra L.; Mustian, Karen M.; Wagner, Lynne I.; Ganz, Patricia A.; Cole, Peter D.; Bakos, Alexis; Root, James C.; Hardy, Kristina; Magnuson, Allison; Ferguson, Robert J.; McDonald, Brenna C.; Saykin, Andrew J.; Gonzalez, Brian D.; Wefel, Jeffrey S.; Morilak, David A.; Dahiya, Saurabh; Heijnen, Cobi J.; Conley, Yvette P.; Morgans, Alicia K.; Mabbott, Donald; Monje, Michelle; Rapp, Stephen R.; Gondi, Vinai; Bender, Catherine; Embry, Leanne; McCaskill Stevens, Worta; Hopkins, Judith O.; St. Germain, Diane; Dorsey, Susan G.; Radiology and Imaging Sciences, School of Medicine
    Cancer-related cognitive impairment is a broad term encompassing subtle cognitive problems to more severe impairment. The severity of this impairment is influenced by host, disease, and treatment factors, and the impairment affects patients before, during, and following cancer treatment. The National Cancer Institute (NCI) Symptom Management and Health-Related Quality of Life Steering Committee (SxQoL SC) convened a clinical trial planning meeting to review the state of the science on cancer-related cognitive impairment and develop phase II/III intervention trials aimed at improving cognitive function in cancer survivors with non-central nervous system disease and longitudinal studies to understand the trajectory of cognitive impairment and contributing factors. Participants included experts in the field of cancer-related cognitive impairment, members of the SxQoL SC, patient advocates, representatives from all 7 NCI Community Oncology Research Program research bases, and the NCI. Presentations focused on the following topics: measurement, lessons learned from pediatric and geriatric oncology, biomarker and mechanism endpoints, longitudinal study designs, and pharmacological and behavioral intervention trials. Panel discussions provided guidance on priority cognitive assessments, considerations for remote assessments, inclusion of relevant biomarkers, and strategies for ensuring broad inclusion criteria. Three clinical trial planning meeting working groups (longitudinal studies as well as pharmacological and behavioral intervention trials) convened for 1 year to discuss and report on top priorities and to design studies. The meeting experts concluded that sufficient data exist to advance phase II/III trials using selected pharmacological and behavioral interventions for the treatment of cancer-related cognitive impairment in the non-central nervous system setting, with recommendations included herein.