There is one clinical trial.
Heart failure is a prevalent and serious public health concern with the growing aging population. Patients with heart failure often experience attention impairment that decreases their ability to perform self-care and diminishes their health-related quality of life. In past studies, 15 - 27% of heart failure patients had attention impairment. Attention is fundamental to human activities including self-care management of heart failure. However, cognitive interventions focusing on attention are scarce in heart failure literature. This study focuses on developing a novel cognitive intervention specifically targeting improved attention and testing its efficacy on improving attention, self-care, and health-related quality of life. The investigators in this study are asking the following 3 questions: 1) does the newly developed cognitive intervention using immersive virtual reality technology (Nature-VR) improve attention compared with the control condition (Urban-VR)?; 2) does Nature-VR intervention improve HF self-care and health-related quality of life compared with Urban-VR control condition?; and 3) are selected biological factors associated with attention function in HF? The virtual reality-based cognitive intervention (Nature-VR) can be an efficacious intervention for the patients to use and enjoy without burdening already reduced attention. This study has great potential to improve attention and prevent attention impairment, thereby leading to healthier lives among heart failure patients.
The dopamine transporter gene (DAT1) (e.g., rs28363170 - 40 bp VNTR) polymorphism and its association with attention will be examined.. Inclusion Criteria: - adults (> 21 years) - diagnosed with chronic HF Stage C - able to communicate in English Exclusion Criteria: - uncorrected visual impairment - major neurological disease (e.g., Alzheimer disease, Parkinson's disease) - major psychiatric disease (e.g., schizophrenia, bipolar disease) Inclusion Criteria: - adults (> 21 years) - diagnosed with chronic HF Stage C - able to communicate in English Exclusion Criteria: - uncorrected visual impairment - major neurological disease (e.g., Alzheimer disease, Parkinson's disease) - major psychiatric disease (e.g., schizophrenia, bipolar disease) Heart Failure Cognitive Dysfunction Heart Failure Cognitive Dysfunction Heart failure (HF) is a prevalent serious chronic illness that affects 6.5 million American.
Description: Performances on the computerized cognitive test of Multi-Source Interference Task will be examined in terms of speed and accuracy. Participants are instructed to identify the target number, which is different than the other 3 numbers provided on the computer screen. There are two types of trials, congruent and incongruent. Congruent trials have a target number that is always matched its position on the button (e.g., 100, 020, or 223), in contrast, incongruent trials have the target number that is never matched with it position in the button (e.g., 010, 233, or 232). Faster response time and lower error rates indicate better attention.
Measure: Changes in attention - Multi-Source Interference Task Time: Baseline, 4 weeks, 8 weeks, and 26 weeksDescription: Participants are instructed to remember the sequence of numbers the data collector told and repeat the numbers right after the instructor finished talking. This test has 2 subsets, Forward-repeat exactly the same sequence, and Backward-repeat the numbers in the backward from last to the first. More digits correctly repeated indicate better attention.
Measure: Changes in attention - Digit Span Test Time: Baseline, 4 weeks, 8 weeks, and 26 weeksDescription: This traditional cognitive test of attention is a paper-pencil based measure and has 2 parts. Part A requires participants to connect a series of randomly arrayed, distinct circles numbered 1 to 25 in correct order as quickly as possible. Part B requires participants to connect a series of 25 circles numbered 1 to 13 randomly intermixed with letters from A to L, alternating between numbers and letters, and proceeding in ascending order (e.g., 1-A-2-B-3 and so on). Faster response time in seconds indicates better attention.
Measure: Changes in attention - Trail Making Test Time: Baseline, 4 weeks, 8 weeks, and 26 weeksDescription: Stroop Test is a color-word test measuring the ability to processe different visual features and ignore distractions. The test has 2 parts of reading letters of color names and colors of color names using 4 color names (i.e., red, blue, yellow, and green). Congruent trials have the same letters and colors of the color names (i.e., red in red color). Incongruent trials have different letters and colors of the color names (i.e., red in blue color). Faster response time and lower error rates indicate better attention.
Measure: Changes in attention - Stroop Test Time: Baseline, 4 weeks, 8 weeks, and 26 weeksDescription: This self-reported questionnaire has 13 items on 0 to 10 response scales asking effectiveness in behaviors requiring attention. Higher scores indicate better subjective attention
Measure: Changes in attention - Attentional Function Index Time: Baseline, 4 weeks, 8 weeks, and 26 weeksDescription: This self-reported questionnaire consists of 29 items divided into 3 scales measuring self-care maintenance, symptom perception, and self-care management. In addition, self-care confidence is measured by additional 10 items. Each scale is scored separately and standardized to achieve a possible score of 0 to 100. Higher scores indicate better self-care of HF.
Measure: Changes in the Self-Care of Heart Failure Index (SCHFI) Time: Baseline, 4 weeks, 8 weeks, and 26 weeksDescription: Minnesota Living with Heart Failure Questionnaire will be used to measure health-related quality of life. This self-report questionnaire consists of 21 items on which patients are asked to rate how their HF condition impacted their physical and emotional health. Lower scores indicate better HRQL.
Measure: Changes in Minnesota Living with Heart Failure Questionnaire (LHFQ) Time: Baseline, 4 weeks, 8 weeks, and 26 weeksDescription: Venipuncture will be performed to draw the blood by following Indiana University general laboratory safety guidelines. Changes in the serum BDNF levels (ng/ml) and its associations with attention will be examined.
Measure: Changes in serum brain-derived neurotrophic factor levels (serum BDNF) Time: Baseline and 4 weeksDescription: Venupucture will be performed to draw the blood for the possible genetic biomarker. The frequency of BDNF Val66Met genotype (e.g., rs6265) will be examined and attention will be examined by the genotype.
Measure: BDNF gene Time: BaselineDescription: Venupucture will be performed to draw the blood for the possible genetic biomarker. The 3 common allele of APOE (i.e., e2, e3, and e4) will be examined. The frequency of APOE genotypes (e.g., rs7412, rs429358) will be examined and attention will be examined by the genotype.
Measure: Apolipoprotein (APOE) gene Time: BaselineDescription: Venupucture will be performed to draw the blood for the possible genetic biomarker. Specifically, dopamine receptor gene 4 (e.g., 48 bp VNTR) polymorphism and its association with attention will be examined.
Measure: Dopamine receptor gene Time: BaselineDescription: Venupucture will be performed to draw the blood for the possible genetic biomarker. The dopamine transporter gene (DAT1) (e.g., rs28363170 - 40 bp VNTR) polymorphism and its association with attention will be examined.
Measure: Dopamine transporter gene Time: Baseline