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Am J Geriatr Psychiatry. 2019 Aug;27(8):809-819. doi: 10.1016/j.jagp.2019.01.211. Epub 2019 Feb 1.

Exercise and Cognitive Training as a Strategy to Improve Neurocognitive Outcomes in Heart Failure: A Pilot Study.

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Emory University Nell Hodgson Woodruff School of Nursing (RAG, SP, EC, BB, KH, BW, DWV), Atlanta. Electronic address:
Emory University Nell Hodgson Woodruff School of Nursing (RAG, SP, EC, BB, KH, BW, DWV), Atlanta.
Emory University School of Medicine (AHM), Winship Cancer Institute, Atlanta.



Mild cognitive impairment, especially memory loss, is prevalent in patients with heart failure (HF) and contributes to poor clinical outcomes and higher mortality.


This study evaluated a combined aerobic exercise and cognitive training (EX/CT) program on memory, executive function, attention, processing speed and reaction time compared to exercise only or a usual care attention control (UCAC) stretching and flexibility program. Participants completed a standardized neurocognitive battery at baseline, 3 months, and 6 months along with demographic, clinical, and functional capacity (6-minute walk test). A linear mixed model analysis was used with comorbidity as a covariate.


Sixty-nine participants were enrolled, the mean age was 61 ± 10 years, 54% were women, 55% were African American, and the mean left ventricular ejection fraction percentage was 35 ± 15. A significant group by time interaction for verbal memory was found at 3 months (F [2, 53] = 4.3, p = 0.018) but was not sustained at 6 months in the EX/CT group. Processing speed/attention differed across treatment groups between baseline and 6 months, but improvement occurred among UCAC participants. There were also significant group differences in the 6MWT distance occurring at 3 months (F [2, 52] = 3.5, p = 0.036); however, significant improvement was observed within the EX/CT group only. There were no significant differences in 6MWT in the other groups at 3 or 6 months.


An EX/CT intervention was associated with improved memory in persons with HF and warrants further investigation in a larger trial. The relationship between functional capacity and cognitive function also needs further study.


Heart failure; cognitive training; exercise; mild cognitive impairment

[Available on 2020-08-01]

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