Key result
Mild cognitive impairment in a single domain was present in 62.5% of acute coronary syndrome patients at cardiac rehabilitation entry, decreasing significantly to 32.5% by follow-up.
Why the study?
Cognitive impairment may limit the uptake of secondary prevention in acute coronary syndrome patients, but is poorly understood, including among cardiac rehabilitation participants.
Observational (n=40)
Mild cognitive impairment is common in post-ACS patients at cardiac rehabilitation entry, especially in those with depression or anxiety, but significantly improves by follow-up.
MCI screening at post-ACS cardiac rehab entry may identify modifiable impairment; leaves open whether targeted interventions improve long-term outcomes.
BACKGROUND: Cognitive impairment may limit the uptake of secondary prevention in acute coronary syndrome patients, but is poorly understood, including in cardiac rehabilitation participants. AIM: The aim of this study was to explore cognitive impairment in relation to psychological state in acute coronary syndrome patients over the course of cardiac rehabilitation and follow-up. METHODS: Acute coronary syndrome patients without diagnosed dementia were assessed on verbal learning, processing speed, executive function and visual attention, at cardiac rehabilitation entry, completion and follow-up and scores adjusted using normative data. The hospital anxiety and depression scale measured psychological state. RESULTS: Participants (n = 40) had an average age of 66.2 (±8.22) years and were 70% men. Mild cognitive impairment occurred at cardiac rehabilitation entry in single 62.5% and multiple 22.5% domains but was significantly less prevalent by cardiac rehabilitation completion (52.5% and 15.0%) and follow-up (32.5% and 7.0%). Domains most often impaired were verbal learning (52.5%) and processing speed (25.6%), again decreasing significantly with time (verbal learning cardiac rehabilitation completion 42.5%, follow-up 22.5%; processing speed cardiac rehabilitation completion 15.0%, follow-up 15.0%). A small group of patients had persistent multiple domain cognitive impairment. At cardiac rehabilitation entry patients with cognitive impairment in processing speed, a single domain or multiple domains had more depression, and patients with cognitive impairment in executive function had more depression and anxiety. CONCLUSIONS: At cardiac rehabilitation entry, mild cognitive impairment is very common in post-acute coronary syndrome patients and worse in patients who have depression or anxiety symptoms. Cognitive impairment decreases significantly by cardiac rehabilitation follow-up. A small proportion of patients has persistent, multiple domain cognitive impairment flagging potential long-term changes and the need for further investigations and cognitive rehabilitation.
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Gallagher et al. (2020) conducted an observational in Acute coronary syndrome (n=40). Cardiac rehabilitation was evaluated on Cognitive impairment in single or multiple domains. Mild cognitive impairment in a single domain was present in 62.5% of acute coronary syndrome patients at cardiac rehabilitation entry, decreasing significantly to 32.5% by follow-up.
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