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Browsing by Author "Lake, Kittie Reid"
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Item Computerized Cognitive Training and 24-Month Mortality in Heart Failure(Wolters Kluwer, 2024) Jung, Miyeon; Smith, Asa B.; Giordani, Bruno; Clark, David G.; Gradus-Pizlo, Irmina; Wierenga, Kelly L.; Lake, Kittie Reid; Pressler, Susan J.; School of NursingBackground: Cognitive dysfunction predicts mortality in heart failure (HF). Computerized cognitive training (CCT) has shown preliminary efficacy in improving cognitive function. However, the relationship between CCT and mortality is unclear. Aims were to evaluate (1) long-term efficacy of CCT in reducing 24-month mortality and (2) age, HF severity, global cognition, memory, working memory, depressive symptoms, and health-related quality of life as predictors of 24-month mortality among patients with HF. Methods: In this prospective longitudinal study, 142 patients enrolled in a 3-arm randomized controlled trial were followed for 24 months. Logistic regression was used to achieve the aims. Results: Across 24 months, 16 patients died (CCT, 8.3%; control groups, 12.8%). Computerized cognitive training did not predict 24-month mortality (odds ratio [OR], 0.65). Older age (OR, 1.08), worse global cognition (OR, 0.73), memory (OR, 0.81), and depressive symptoms (OR, 1.10) at baseline predicted 24-month mortality. Conclusions: Efficacious interventions are needed to improve global cognition, memory, and depressive symptoms and reduce mortality in HF.Item 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 NursingBackground: 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.