Cognitive deficits and self-care behaviors in elderly adults with heart failure

Abstract

IntroductionElderly adults with heart failure (HF) may have problems with self-care behaviors because of cognitive deficits. Self-care deficits have been found to be significantly associated with negative health care outcomes among HF patients. The aim of this paper was to assess cognitive deficits and the level of self-care ability in elderly patients with HF, and to determine if a relationship exists between cognitive deficits and self-care.Materials and methodsThe study included 270 elderly patients (mean age: 72.5 years) with HF. We used the Mini Mental State Examination Scale (MMSE) to evaluate cognitive functioning, and the European Heart Failure Self-care Behavior Scale, revised into a nine-item scale (EHFScBS-9), to evaluate self-care behaviors. Associations between the variables were examined using multiple regression analysis.ResultsLower scores in both MMSE and EHFScBS-9 questionnaires were correlated with older age, living alone, lower education, longer duration of illness, higher number of rehospitalizations, as well as lower left ventricular ejection fraction and higher New York Heart Association (NYHA) class. The multiple regression analysis was used for evaluation of the impact of the following predictors: MMSE score, age, duration of illness, ejection fraction, number of hospitalizations, sex, residence, education, relationship status, and NYHA class on EHFScBS-9 score.ConclusionsElderly patients with HF may have worse self-care behaviors because of their cognitive deficits. Age was the strongest predictor of worse MMSE scores. Multidisciplinary health teams should pay attention to the special needs of elderly patients who live with their illness for many years and have no social support because of living alone.

Knowledge about heart failure and self-care persists following outpatient programme- a prospective cohort study from the Faroe Islands

“…Cognitive abilities are required to maintain a certain level of knowledge and perform self-care. The elderly can have problems with hearing, vision and cognitive deficits, these factors can all influence the outcome of patient education and become a barrier to attending CR [27]. The elderly represent a large part of the overall HF population, and many of them are widowed and living alone.…”

The roles of health literacy and social support in improving adherence to self‐care behaviours among older adults with heart failure

“…Older adults with HF are less likely to adhere to self‐care behaviours than younger patients are (Cocchieri et al., 2015). Hence, studies to discover meaningful factors influencing self‐care in patients with HF have continued and in recent years, significant factors have been reported, including age, education, New York Heart Association (NYHA) functional class, comorbidity, disease knowledge, health literacy and social support (Beckie et al, 2017; Prochota, Szwamel, & Uchmanowicz, 2019; Seid, Abdela, & Zeleke, 2019; Uchmanowicz et al., 2017). However, the implementation of self‐care for older patients with HF, in particular, is still an issue that needs attention (Prochota et al., 2019; Uchmanowicz et al., 2017).…”

Diabetes Mellitus

“…Walker et al [31] found that social determinants of health were significantly associated with diabetic knowledge, self-care, and outcomes. Uchmanowicz et al [32] suggested that higher education was associated with higher cognitive function and better self-care.…”