Targeting Cognitive Function and Interoceptive Awareness to Improve Self-management in Patients With Co-morbid Heart Failure and Cognitive Impairment.
The Miriam Hospital
Summary
This projects studies the role of mindfulness training (MT) to improve self-care among patients with heart failure and cognitive impairment.
Description
Stable outpatients patients with co-morbid heart failure (HF) and mild cognitive impairment (MCI) (n=176) will be randomly assigned to phone-delivered MT (a weekly, 30-minute session for 8 weeks integrated with 20-min daily guided individual practice via digital recordings) plus enhanced usual care (EUC) or to EUC alone. Per current recommendations, usual care will be enhanced in both groups with self-care education materials. At baseline, 3 months (end of treatment), and 9 months since baseline participants will undergo comprehensive assessments of cognitive function, psycho-behavioral factor…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Age \> 18 years old * A documented diagnosis of HF * Access to a telephone * Mild cognitive impairment (MoCA score \< = 26) * Ability to understand and speak English or Spanish Exclusion Criteria: * Unwillingness/inability to provide informed consent * Reversible causes of HF (e.g., takotsubo syndrome; myocarditis) * Severe hearing impairment not allowing phone delivery * Suicidal ideation or plan * Current (at least once a month) mind/body practice * Planning to move out of the area during the study period * Severe cognitive impairment (MoCA scores \< 15) * New York H…
Interventions
- BehavioralMindfulness Training + Enhanced Usual Care
Participants will receive a 30-minute, individual, phone-delivered session once a week for 8 weeks. MT involves training in the following (1) Awareness of breath; (2) Body scan; (3) Directing attention to simple activities of daily life; (4) Becoming aware of own thoughts and emotions; (5) "Open awareness" - a technique by which the participant is invited to direct his/her attention to any event arising in their field of experience at a given moment. In addition, participants will practice mindfulness techniques for 20 minutes daily on their own with the guidance of a digitally recorded, standardized guided mindfulness practice.
- OtherEnhanced Usual Care
Usual care will be enhanced in BOTH conditions with printed education materials provided to all participants using publicly available materials (the "Healthier Living with Heart Failure" guide available at the AHA Heart Failure Resource Center).66 The guide is organized in 7 chapters containing information on topics such as understanding HF, making healthy lifestyle changes, managing HF symptoms, taking medications, and living well with HF. Printed materials will be mailed weekly to all participants during the first 8 weeks of the study.
Location
- The Miriam HospitalProvidence, Rhode Island