Is cognitive function a determinant of exercise capacity in patients with coronary artery disease?

Abstract Background Exercise is often referred to as a 'polypill' due to its numerous beneficial effects on cardiovascular risk factors and the physiology of the cardiovascular system. Skeletal muscle weakness, cardiac ischemia, angina, and medications adversely affect exercise capacity in patients with coronary artery disease. In atherosclerotic patients, the presence of coronary microvascular dysfunction as determined by low coronary flow reserve is associated with abnormal cerebral flow hemodynamics and mild but significant impairment in cognitive function. Purpose The aim of our study was to investigate the relationship between cognitive status and exercise capacity in patients with coronary artery disease. Methods The study included 30 patients (59.8 ±7.20 years, 73% men) diagnosed with coronary artery disease. Patients were evaluated for cognitive impairments with the Montreal Cognitive Assessment (MoCA), and for exercise capacity with incremental shuttle walk test (ISWT). Additionally, the study documented sociodemographic, and physiological variables, number of cardiac risk factors with the cardiovascular risk factors questionnaire (obesity, physical inactivity, hyperlipidemia, hypertension, diabetes mellitus, smoking), International Physical Activity Questionnaire-Short Form, and comorbidities. Results Patients' waist hip ratio was 0.93±0.08, and body mass index was 27.54±4.24. About 43.3% (n=13) of the patients were actively employed. The number of risk factors was median 4 (min-max=2-7) and the number of comorbidities was median 0 (min-max: 0-5). Among the study participants, 96.6% (n=29) were physically inactive. There was a positive, high level, and statistically significant correlation between the ISWT distance and MoCA score (r=0.82, p=0.004). Conclusion The cognitive status of the patients significantly influenced their exercise capacity. Physiotherapists should consider patients' cognitive status when determining exercise capacity to ensure accurate measurements. Considering the cognitive status of patients with coronary artery disease when planning rehabilitation programs may be crucial for the success of these programs. Assessing cognitive functions and exercise ability before starting a cardiac rehabilitation program is critical for participation and commitment to exercise regimens.