The association between cognitive function and objective adherence to dietary sodium guidelines in patients with heart failure

Mary A. Dolansky, Julie T. Schaefer, Misty A.W. Hawkins, John Gunstad, Anup Basuray, Joseph D. Redle, James C. Fang, Richard A. Josephson, Shirley M. Moore, Joel W. Hughes

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Although cognitive impairment is common in heart failure (HF) patients, its effects on sodium adherence recommendations are unknown. Purpose: Our aim is to examine if cognitive function is associated with patient sodium adherence. Methods: Sodium collection/excretion and cognitive function were assessed for 339 HF patients over a 5–8-week period. Neuropsychological testing was performed at baseline (Visit 1), whereas two 24-hour urine samples were collected within 7 weeks postbaseline. The ability to collect two 24-hour urine samples and the estimation of sodium excretion levels from these samples were used to estimate sodium adherence recommendations. Results: Nearly half (47%) of the study participants (n=159) were unable to give two valid 24-hour urine samples. Participants who were unable to adhere to two valid 24-hour urine samples had significantly poorer attention and global cognition tests (P<0.044), with a trend for poorer executive function (P=0.064). Among those with valid samples, urine sodium level was not associated with global cognitive function, attention, executive function, or memory after adjusting for covariates. Female sex was associated with lower sodium excretion (all P<0.01); individuals with knowledge of sodium guidelines had less intake of sodium, resulting in excretion of less sodium (all P≤0.03). Conversely, higher socioeconomic status (SES) and body mass index (BMI) were associated with greater sodium (all P≤0.02 and P≤0.01). Conclusion: Adherence to urine sodium collection was poor, especially among those with poorer cognitive function. Sodium consumption exceeded recommended amounts and was unrelated to cognitive function. Interventions for improving sodium adherence should focus on at-risk groups (high SES and BMI) and at improving knowledge of recommended salt intake.

Original languageEnglish
Pages (from-to)233-241
Number of pages9
JournalPatient Preference and Adherence
Volume10
DOIs
StatePublished - 2 Mar 2016
Externally publishedYes

Fingerprint

Dietary Sodium
Nutrition Policy
Cognition
Heart Failure
Sodium
Urine
social status
Executive Function
Social Class
cognition
Body Mass Index
Urine Specimen Collection
Aptitude
ability
trend
Patient Compliance

Keywords

  • Attention
  • Cardiac
  • Executive function
  • Memory
  • Salt intake
  • Urine collection

Cite this

Dolansky, Mary A. ; Schaefer, Julie T. ; Hawkins, Misty A.W. ; Gunstad, John ; Basuray, Anup ; Redle, Joseph D. ; Fang, James C. ; Josephson, Richard A. ; Moore, Shirley M. ; Hughes, Joel W. / The association between cognitive function and objective adherence to dietary sodium guidelines in patients with heart failure. In: Patient Preference and Adherence. 2016 ; Vol. 10. pp. 233-241.
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abstract = "Background: Although cognitive impairment is common in heart failure (HF) patients, its effects on sodium adherence recommendations are unknown. Purpose: Our aim is to examine if cognitive function is associated with patient sodium adherence. Methods: Sodium collection/excretion and cognitive function were assessed for 339 HF patients over a 5–8-week period. Neuropsychological testing was performed at baseline (Visit 1), whereas two 24-hour urine samples were collected within 7 weeks postbaseline. The ability to collect two 24-hour urine samples and the estimation of sodium excretion levels from these samples were used to estimate sodium adherence recommendations. Results: Nearly half (47{\%}) of the study participants (n=159) were unable to give two valid 24-hour urine samples. Participants who were unable to adhere to two valid 24-hour urine samples had significantly poorer attention and global cognition tests (P<0.044), with a trend for poorer executive function (P=0.064). Among those with valid samples, urine sodium level was not associated with global cognitive function, attention, executive function, or memory after adjusting for covariates. Female sex was associated with lower sodium excretion (all P<0.01); individuals with knowledge of sodium guidelines had less intake of sodium, resulting in excretion of less sodium (all P≤0.03). Conversely, higher socioeconomic status (SES) and body mass index (BMI) were associated with greater sodium (all P≤0.02 and P≤0.01). Conclusion: Adherence to urine sodium collection was poor, especially among those with poorer cognitive function. Sodium consumption exceeded recommended amounts and was unrelated to cognitive function. Interventions for improving sodium adherence should focus on at-risk groups (high SES and BMI) and at improving knowledge of recommended salt intake.",
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Dolansky, MA, Schaefer, JT, Hawkins, MAW, Gunstad, J, Basuray, A, Redle, JD, Fang, JC, Josephson, RA, Moore, SM & Hughes, JW 2016, 'The association between cognitive function and objective adherence to dietary sodium guidelines in patients with heart failure', Patient Preference and Adherence, vol. 10, pp. 233-241. https://doi.org/10.2147/PPA.S95528

The association between cognitive function and objective adherence to dietary sodium guidelines in patients with heart failure. / Dolansky, Mary A.; Schaefer, Julie T.; Hawkins, Misty A.W.; Gunstad, John; Basuray, Anup; Redle, Joseph D.; Fang, James C.; Josephson, Richard A.; Moore, Shirley M.; Hughes, Joel W.

In: Patient Preference and Adherence, Vol. 10, 02.03.2016, p. 233-241.

Research output: Contribution to journalArticle

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T1 - The association between cognitive function and objective adherence to dietary sodium guidelines in patients with heart failure

AU - Dolansky, Mary A.

AU - Schaefer, Julie T.

AU - Hawkins, Misty A.W.

AU - Gunstad, John

AU - Basuray, Anup

AU - Redle, Joseph D.

AU - Fang, James C.

AU - Josephson, Richard A.

AU - Moore, Shirley M.

AU - Hughes, Joel W.

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N2 - Background: Although cognitive impairment is common in heart failure (HF) patients, its effects on sodium adherence recommendations are unknown. Purpose: Our aim is to examine if cognitive function is associated with patient sodium adherence. Methods: Sodium collection/excretion and cognitive function were assessed for 339 HF patients over a 5–8-week period. Neuropsychological testing was performed at baseline (Visit 1), whereas two 24-hour urine samples were collected within 7 weeks postbaseline. The ability to collect two 24-hour urine samples and the estimation of sodium excretion levels from these samples were used to estimate sodium adherence recommendations. Results: Nearly half (47%) of the study participants (n=159) were unable to give two valid 24-hour urine samples. Participants who were unable to adhere to two valid 24-hour urine samples had significantly poorer attention and global cognition tests (P<0.044), with a trend for poorer executive function (P=0.064). Among those with valid samples, urine sodium level was not associated with global cognitive function, attention, executive function, or memory after adjusting for covariates. Female sex was associated with lower sodium excretion (all P<0.01); individuals with knowledge of sodium guidelines had less intake of sodium, resulting in excretion of less sodium (all P≤0.03). Conversely, higher socioeconomic status (SES) and body mass index (BMI) were associated with greater sodium (all P≤0.02 and P≤0.01). Conclusion: Adherence to urine sodium collection was poor, especially among those with poorer cognitive function. Sodium consumption exceeded recommended amounts and was unrelated to cognitive function. Interventions for improving sodium adherence should focus on at-risk groups (high SES and BMI) and at improving knowledge of recommended salt intake.

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