Exercise and Cognitive Training as a Strategy to Improve Neurocognitive Outcomes in Heart Failure: A Pilot Study

Rebecca A. Gary, Sudeshna Paul, Elizabeth Corwin, Brittany Butts, Andrew H. Miller, Kenneth Hepburn, Bryan Williams, Drenna Waldrop-Valverde

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Objective: Mild cognitive impairment, especially memory loss, is prevalent in patients with heart failure (HF) and contributes to poor clinical outcomes and higher mortality. Methods: This study evaluated a combined aerobic exercise and cognitive training (EX/CT) program on memory, executive function, attention, processing speed and reaction time compared to exercise only or a usual care attention control (UCAC) stretching and flexibility program. Participants completed a standardized neurocognitive battery at baseline, 3 months, and 6 months along with demographic, clinical, and functional capacity (6-minute walk test). A linear mixed model analysis was used with comorbidity as a covariate. Results: Sixty-nine participants were enrolled, the mean age was 61 ± 10 years, 54% were women, 55% were African American, and the mean left ventricular ejection fraction percentage was 35 ± 15. A significant group by time interaction for verbal memory was found at 3 months (F [2, 53] = 4.3, p = 0.018) but was not sustained at 6 months in the EX/CT group. Processing speed/attention differed across treatment groups between baseline and 6 months, but improvement occurred among UCAC participants. There were also significant group differences in the 6MWT distance occurring at 3 months (F [2, 52] = 3.5, p = 0.036); however, significant improvement was observed within the EX/CT group only. There were no significant differences in 6MWT in the other groups at 3 or 6 months. Conclusion: An EX/CT intervention was associated with improved memory in persons with HF and warrants further investigation in a larger trial. The relationship between functional capacity and cognitive function also needs further study.

Original languageEnglish (US)
Pages (from-to)809-819
Number of pages11
JournalAmerican Journal of Geriatric Psychiatry
Issue number8
StatePublished - Aug 2019
Externally publishedYes


  • Heart failure
  • cognitive training
  • exercise
  • mild cognitive impairment

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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