Aerobic Exercise as an Adjunct Therapy for Improving Cognitive Function in Heart Failure

Abstract

Persons with heart failure (HF) are typically older and are at a much higher risk for developing cognitive impairment (CI) than persons without HF. Increasingly, CI is recognized as a significant, independent predictor of worse clinical outcomes, more frequent hospital readmissions, and higher mortality rates in persons with HF. CI can have devastating effects on ability to carry out HF effective self-care behaviors. If CI occurs, however, there are currently no evidence based guidelines on how to manage or improve cognitive function in this population. Improvement in cognition has been reported following some therapies in HF and is thought to be the consequence of enhanced cerebral perfusion and oxygenation, suggesting that CI may be amenable to intervention. Because there is substantial neuronal loss with dementia and no effective restorative therapies, interventions that slow, reverse, or prevent cognitive decline are essential. Aerobic exercise is documented to increase cerebral perfusion and oxygenation by promoting neuroplasticity and neurogenesis and, in turn, cognitive functioning. Few studies have examined exercise as a potential adjunct therapy for attenuating or alleviating cognitive decline in HF. In this review, the potential benefit of aerobic exercise on cognitive functioning in HF is presented along with future research directions.

Team-Based Care for Managing Noncardiac Conditions in Patients with Heart Failure

“…54 In general, pharmacotherapy for HF may improve cognitive impairment in patients with HF 55 ; exercise may also have salutary effects on cognition. 56 Multisource disease management programs for dementia improve outcomes for both patients 57 and caregivers. 58 Whether team-based care strategies emphasizing effective pharmacologic and nonpharmacologic therapies in co-occurring HF and dementia can improve health care delivery and outcomes is not known.…”

An exploratory randomized sub-study of light-to-moderate intensity exercise on cognitive function, depression symptoms and inflammation in older adults with heart failure

“…The Institute of Medicine (IOM) lists physical activity as its primary recommendation for maintaining cognitive health in older persons (11). Because dementia is associated with considerable neuronal damage for which there is a lack of pharmacological treatments, developing behavioral interventions that prevent, slow-down, or reverse cognitive deterioration are imperative (12). Few older adult patients with HF attend traditional cardiac rehabilitation.…”

Effects of Endurance-Focused Physical Activity Interventions on Brain Health

“…Authors have recently published eight literature reviews examining physical activity interventions and cognitive function (Cumming, Tyedin, Churilov, Morris, & Bernhardt, 2012;Farina, Rusted, & Tabet, 2014;Gary & Brunn, 2014;Gates, Fiatarone Singh, Sachdev, & Valenzuela, 2013;Lautenschlager, Cox, & Kurz, 2010;Law, Barnett, Yau, & Gray, 2014;Littbrand, Stenvall, & Rosendahl, 2011;Smith et al, 2013;Snowden et al, 2011). However, most (n ¼ 6) focused on participants with specific disease processes, while one examined combined cognitive and exercise interventions and did not examine the impact of physical activity separately (Law et al, 2014).…”