Evaluating Depressive Symptoms, BDNF Val66Met, and APOE-ε4 as Moderators of Response to Computerized Cognitive Training in Heart Failure

dc.contributor.authorPressler, Susan J.
dc.contributor.authorJung, Miyeon
dc.contributor.authorGiordani, Bruno
dc.contributor.authorTitler, Marita G.
dc.contributor.authorGradus-Pizlo, Irmina
dc.contributor.authorReid Lake, Kittie
dc.contributor.authorWierenga, Kelly L.
dc.contributor.authorClark, David G.
dc.contributor.authorPerkins, Susan M.
dc.contributor.authorSmith, Dean G.
dc.contributor.authorMocci, Evelina
dc.contributor.authorDorsey, Susan G.
dc.contributor.departmentSchool of Nursing
dc.date.accessioned2024-08-01T14:21:46Z
dc.date.available2024-08-01T14:21:46Z
dc.date.issued2023
dc.description.abstractBackground: 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.
dc.eprint.versionAuthor's manuscript
dc.identifier.citationPressler SJ, Jung M, Giordani B, et al. Evaluating depressive symptoms, BDNF Val66Met, and APOE-ε4 as moderators of response to computerized cognitive training in heart failure. Heart Lung. 2023;59:146-156. doi:10.1016/j.hrtlng.2023.02.002
dc.identifier.urihttps://hdl.handle.net/1805/42539
dc.language.isoen_US
dc.publisherElsevier
dc.relation.isversionof10.1016/j.hrtlng.2023.02.002
dc.relation.journalHeart & Lung
dc.rightsPublisher Policy
dc.sourcePMC
dc.subjectHeart failure
dc.subjectCongestive heart failure
dc.subjectComputerized cognitive training
dc.subjectMemory
dc.subjectBrain-derived neurotrophic factor
dc.subjectHealth-related quality of life
dc.titleEvaluating Depressive Symptoms, BDNF Val66Met, and APOE-ε4 as Moderators of Response to Computerized Cognitive Training in Heart Failure
dc.typeArticle
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