Cognitive reserve moderates the association between heart failure and cognitive impairment

Background: Cognitive impairment in persons with heart failure is common. Theories of cognitive reserve suggest that premorbid factors, such as intellectual ability, may provide a buffer against cognitive impairment due to neuropathological insult. No study has examined the influence of cognitive reserve on cognitive functioning in older adults with heart failure. Aim: This study examined whether cognitive reserve moderates the relationship between heart failure severity and cognitive function. Methods: A total of 157 persons with heart failure (69.26 +/- 9.26 years; 39% female) completed neuropsychological testing and a brief fitness assessment. Cognitive reserve was operationalized using estimated premorbid intellect on the American National Adult Reading Test (AMNART). Results: A moderation analysis was performed using hierarchical regression models for each cognitive domain. An interaction term between the AMNART and 2-Minute Step Test was created and entered into the final block of the model, with demographic, psychosocial, and heart failure severity entered in the previous blocks. The interaction term was significant for attention, t(155) = -2.54, p = .012, executive function, t(155) = -3.30, p = .001, and language, t(155) = -2.83, p = .005, domains. Conclusion: The current findings suggest that cognitive reserve moderates the association between heart failure severity and cognitive function in multiple cognitive domains. Further work is needed to clarify the mechanisms by which cognitive reserve attenuates cognitive impairment in this population.