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Gender Differences in Cognitive Test Performance in Adults With Heart Failure

Rochette, Amber D. BA; Spitznagel, Mary Beth PhD; Sweet, Lawrence H. PhD; Cohen, Ronald A. PhD; Josephson, Richard PhD; Hughes, Joel PhD; Gunstad, John PhD

Journal of Cardiovascular Nursing: May/June 2017 - Volume 32 - Issue 3 - p 212–217
doi: 10.1097/JCN.0000000000000330
ARTICLES: Heart Failure

Background: Cognitive deficits are found in up to 73% of persons with heart failure (HF) and are associated with increased mortality and other poor clinical outcomes. It is known that women have better memory test performance than men do in healthy samples, but gender differences in cognitive performance in the context of HF are not well understood and may have important clinical implications.

Objective: The objective of this study was to examine possible gender differences in cognitive function in a sample of individuals with HF (98.9% New York Heart Association class II and III).

Methods: A total of 183 adults with HF (116 men and 67 women) completed a neuropsychological test battery as part of a larger project. Measures were chosen to assess functioning in attention/executive function and memory.

Results: After controlling for demographic and medical factors, multivariate analysis of covariance revealed that men and women differed on memory test performance (λ = 0.90, F4, 169 = 4.76, P = .001). Post hoc comparisons revealed that women performed better on California Verbal Learning Test Learning, Short Recall, and Delayed Recall. No differences emerged on tests of attention/executive function (λ = 0.97, F5, 168 = 0.96, P = .44).

Conclusions: In this sample of persons with HF, men exhibited poorer performance on memory measures than women did. Future studies are needed to determine the underlying mechanisms for this pattern and its possible influence on daily function.

Amber D. Rochette, BA Graduate Student, Department of Psychological Sciences, Kent State University, Ohio.

Mary Beth Spitznagel, PhD Assistant Professor, Department of Psychological Sciences, Kent State University, and Clinical Psychologist, Department of Psychiatry, Summa Health System, Akron, Ohio.

Lawrence H. Sweet, PhD Professor, Department of Psychology, University of Georgia, Athens.

Ronald A. Cohen, PhD Professor, Department of Aging & Geriatric Research, University of Florida, Gainesville.

Richard Josephson, PhD Professor of Medicine, Harrington Heart & Vascular Institute, University Hospitals Case Medical Center, and Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.

Joel Hughes, PhD Professor, Department of Psychological Sciences, Kent State University, Ohio.

John Gunstad, PhD Professor, Department of Psychological Sciences, Kent State University, Ohio.

This work funded by the National Institutes of Health (HL089311).

Dr Gunstad reports grants from the National Institutes of Health during the conduct of the study. The other authors have no conflicts of interest to disclose.

Correspondence John Gunstad, PhD, Department of Psychological Sciences, Kent State University, 144 Kent Hall, Kent, OH 44242 (

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